| Entity Name: | LAKESIDE QUALITY HOME HEALTH CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Aug 2004 (20 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 22 Oct 2007 (17 years ago) |
| Document Number: | P04000118083 |
| FEI/EIN Number | 202120308 |
| Address: | 109 S Lake Ave, PAHOKEE, FL, 33476, US |
| Mail Address: | 109 S Lake Ave, PAHOKEE, FL, 33476, US |
| ZIP code: | 33476 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720179070 | 2006-09-28 | 2010-01-07 | 485 WEST MAIN ST,, SUITE A, PAHOKEE, FL, 334762405, US | 485 WEST MAIN ST,, SUITE A, PAHOKEE, FL, 334762405, US | |||||||||||||||||||||||||
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| Phone | +1 561-924-7675 |
| Fax | 5619247677 |
Authorized person
| Name | MS. NATALIA M ROQUE |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 5619247675 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299992191 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 651221600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROQUE NATALIA M | Agent | 10485 NW 130 St, Hialeah Garden, FL, 33018 |
| Name | Role | Address |
|---|---|---|
| ROQUE NATALIA M | President | 10485 NW 130 St, Hialeah Garden, FL, 33018 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-26 | 10485 NW 130 St, Hialeah Garden, FL 33018 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-10 | 109 S Lake Ave, PAHOKEE, FL 33476 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-10 | 109 S Lake Ave, PAHOKEE, FL 33476 | No data |
| AMENDMENT | 2007-10-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-16 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-03-10 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-01-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
