| Entity Name: | PEMBROKE PINES COMMUNITY HEALTH CENTER, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 15 Oct 2020 (4 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 26 Aug 2021 (3 years ago) |
| Document Number: | N20000011579 |
| FEI/EIN Number | 85-3480203 |
| Address: | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 33027 |
| Mail Address: | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 33027 |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326774308 | 2022-08-01 | 2022-08-01 | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 330271721, US | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 330271721, US | |||||||||||||||
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| Phone | +1 954-442-0029 |
| Fax | 9543572353 |
Authorized person
| Name | CLEOPATRA GORDON-PUSEY |
| Role | OWNER |
| Phone | 9544420029 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PUSEY BRAMWELL BJR | Agent | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 33027 |
| Name | Role | Address |
|---|---|---|
| PUSEY BRAMWELL BJR | President | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 30027 |
| Name | Role | Address |
|---|---|---|
| McElroy Santhia | Vice President | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 30027 |
| Name | Role | Address |
|---|---|---|
| BARRETT JOAN | Secretary | 222 S FLAMINGO RD, PEMBROKE PINES, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-08-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-14 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-25 |
| Amendment | 2021-08-26 |
| ANNUAL REPORT | 2021-04-21 |
| Domestic Non-Profit | 2020-10-15 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
