| Entity Name: | VITAL HEALTH SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Jun 2002 (23 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 19 May 2022 (3 years ago) |
| Document Number: | P02000067044 |
| FEI/EIN Number | 043689277 |
| Address: | 8600 NW South River Drive, SUITE 99, Medley, FL, 33166, US |
| Mail Address: | 8600 NW S RIVER DRIVE, SUITE 99, MEDLEY, FL, 33166, US |
| ZIP code: | 33166 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548346828 | 2006-10-28 | 2011-12-14 | 5787A NW 151ST ST, MIAMI LAKES, FL, 330142490, US | 5787A NW 151ST ST, MIAMI LAKES, FL, 330142490, US | |||||||||||||||||||||||||
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| Phone | +1 305-817-8799 |
| Fax | 3058178648 |
Authorized person
| Name | MS. VICKY B PUNZALAN |
| Role | PRESIDENT |
| Phone | 3056060228 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | HHA29992169 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 651282800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PUNZALAN VICKY | Agent | 8600 NW South River Drive, Medley, FL, 33166 |
| Name | Role | Address |
|---|---|---|
| PUNZALAN VICKY B | President | 15947 SW 112 PLACE, MIAMI, FL, 33157 |
| Name | Role | Address |
|---|---|---|
| PUNZALAN VICKY B | Treasurer | 15947 SW 112 PLACE, MIAMI, FL, 33157 |
| Name | Role | Address |
|---|---|---|
| PUNZALAN VICKY B | Director | 15947 SW 112 PLACE, MIAMI, FL, 33157 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-23 | 8600 NW South River Drive, SUITE 99, Medley, FL 33166 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-23 | 8600 NW South River Drive, SUITE 99, Medley, FL 33166 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-23 | 8600 NW South River Drive, SUITE 99, Medley, FL 33166 | No data |
| AMENDMENT | 2022-05-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-03-12 | PUNZALAN, VICKY | No data |
| REINSTATEMENT | 2014-03-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| AMENDMENT | 2004-08-11 | No data | No data |
| AMENDMENT | 2002-12-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| AMENDED ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2023-01-13 |
| Amendment | 2022-05-19 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-05-01 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-04-19 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2777348802 | 2021-04-13 | 0455 | PPP | 5787A NW 151st St, Miami Lakes, FL, 33014-2490 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
