| Entity Name: | ONE LOVE MEDICAL SERVICES CORPORATION |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 29 May 2024 (8 months ago) |
| Document Number: | N24000006528 |
| FEI/EIN Number | 993370254 |
| Address: | 1701 SE HILLMOOR DR, PORT ST LUCIE, FL, 34952, US |
| Mail Address: | 1701 SE HILLMOOR DR, PORT ST LUCIE, FL, 34952, US |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013741552 | 2024-08-28 | 2024-08-28 | 1701 SE HILLMOOR DR # 17, PORT SAINT LUCIE, FL, 349527552, US | 1701 SE HILLMOOR DR # 17, PORT SAINT LUCIE, FL, 349527552, US | |||||||||||||
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| Phone | +1 561-247-0248 |
Authorized person
| Name | JASON WATT |
| Role | OWNER |
| Phone | 5612470248 |
Taxonomy
| Taxonomy Code | 261QR0401X - Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VERMA RAJAT | Agent | 10299 SOUTHERN BLVD, ROYAL PALM BEACH, FL, 33421 |
| Name | Role | Address |
|---|---|---|
| WATT JASON | President | 3601 NW FEDERAL HIGHWAY, JENSEN BEACH, FL, 34957 |
| Name | Role | Address |
|---|---|---|
| BEISER NICOLE | Vice President | 3140 S BROCKSMITH ROAD, FORT PIERCE, FL, 34945 |
| Name | Role | Address |
|---|---|---|
| KUCHERA JAY | Secretary | 1500 SE LEGACY COVE CIRCLE, STUART, FL, 34997 |
| Name | Role | Address |
|---|---|---|
| BOLTSON KYLE | Officer | 2190 SE SUNFLOWER STREET, PORT SAINT LUCIE, FL, 34952 |
| DAWSON JOSE | Officer | 1040 PULITZER ROAD, FORT PIERCE, FL, 34945 |
| VANDUZER DANIELLE | Officer | 7227 MYSTIC WAY, PORT ST LUCIE, FL, 34986 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-14 | 1701 SE HILLMOOR DR, #17, PORT ST LUCIE, FL 34952 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-14 | 1701 SE HILLMOOR DR, #17, PORT ST LUCIE, FL 34952 | No data |
| Name | Date |
|---|---|
| Domestic Non-Profit | 2024-05-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
