| Entity Name: | PRESTIGE MEDICAL CLINIC INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 19 Sep 2022 (2 years ago) |
| Document Number: | N22000010712 |
| FEI/EIN Number | 92-0347532 |
| Address: | 4699 N. FEDERAL HIGHWAY, SUITE 209 (F-M), POMPANO BEACH, FL, 33064, UN |
| Mail Address: | 4699 N. FEDERAL HIGHWAY, SUITE 209 (F-M), POMPANO BEACH, FL, 33064, UN |
| ZIP code: | 33064 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013698604 | 2023-07-27 | 2023-07-27 | 4699 N FEDERAL HWY # 209F-M, POMPANO BEACH, FL, 330646510, US | 4699 N FEDERAL HWY STE 209F-M, POMPANO BEACH, FL, 330646510, US | |||||||||||||||
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| Phone | +1 954-800-6000 |
| Fax | 9543028409 |
Authorized person
| Name | ROSE JEAN |
| Role | ADMINSTRATOR |
| Phone | 5617025740 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JEAN ROSE | Agent | 4699 N. FEDERAL HIGHWAY, POMPANO BEACH, FL, 33064 |
| Name | Role | Address |
|---|---|---|
| JEAN ROSE | President | 4699 N. FEDERAL HIGHWAY SUITE 209 (F-M), POMPANO BEACH, FL, 33064 |
| Name | Role | Address |
|---|---|---|
| EXILUS REGINALD | Vice President | 4699 N. FEDERAL HIGHWAY SUITE 209 (F-M), POMPANO BEACH, FL, 33064 |
| Name | Role | Address |
|---|---|---|
| DUVERNOIS EMILE | Chief Financial Officer | 4699 N. FEDERAL HIGHWAY SUITE 209 (F-M), POMPANO BEACH, UN, 33064 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-05-01 |
| Domestic Non-Profit | 2022-09-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
