| Entity Name: | MOBIL LAB FOR ALL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 05 Mar 2019 (6 years ago) |
| Document Number: | N19000002584 |
| FEI/EIN Number | 83-3637362 |
| Address: | 1053 SW 12TH STREET, BOCA RATON, FL, 33486, US |
| Mail Address: | 1053 SW 12TH STREET, BOCA RATON, FL, 33486, US |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770103699 | 2020-04-21 | 2021-02-04 | 1053 SW12TH ST, BOCA RATON, FL, 33486, US | 1053 SW 12TH ST, BOCA RATON, FL, 334865490, US | |||||||||||||||||||
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| Phone | +1 561-386-7182 |
Authorized person
| Name | DR. ROSA I RIVERA |
| Role | PROPRIETOR |
| Phone | 5613867182 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | 26988979 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHIELDS BOBBY LESQ. | Agent | 2350 NW 36TH AVENUE, COCONUT CREEK, FL, 33066 |
| Name | Role | Address |
|---|---|---|
| RIVERA ROSA I | President | 1053 SW 12TH STREET, BOCA RATON, FL, 33486 |
| Name | Role | Address |
|---|---|---|
| PLANA JAIME M | Vice President | 1053 SW 12TH STREET, BOCA RATON, FL, 33486 |
| Name | Role | Address |
|---|---|---|
| PLANA JAIME M | Director | 1053 SW 12TH STREET, BOCA RATON, FL, 33486 |
| SANCHEZ MIGDALIA | Director | 804 8TH WAY, WEST PALM BEACH, FL, 33407 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-03-14 |
| Domestic Non-Profit | 2019-03-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
