| Entity Name: | MERCY FAMILY & URGENT CARE, INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Jan 2005 (20 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 20 Feb 2018 (7 years ago) |
| Document Number: | P05000002738 |
| FEI/EIN Number | 56-2494196 |
| Address: | 3511 NW 8TH AVENUE, 1-2, POMPANO BEACH, FL 33064 |
| Mail Address: | 2137 SeaPines Way, Coral Springs, FL 33071 |
| ZIP code: | 33064 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477724169 | 2008-03-20 | 2015-05-14 | 3511 NW 8TH AVE, SUITE 1-2, POMPANO BEACH, FL, 330643055, US | 3511 NW 8TH AVE, SUITE 1-2, POMPANO BEACH, FL, 330643055, US | |||||||||||||||||||||||||
|
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| Phone | +1 954-783-0621 |
| Fax | 9547830622 |
Authorized person
| Name | DR. NIERMALA WASHINGTON |
| Role | TREASURER |
| Phone | 9547830621 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 271039100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS, LEVI GJR. | Agent | 200 SE 13TH STREET, FT. LAUDERDALE, FL 33301 |
| Name | Role | Address |
|---|---|---|
| WASHINGTON, NIERMALA, M.D. | PRESIDENT | 2137 SEA PINES WAY, CORAL SPRINGS, FL 33071 |
| Name | Role | Address |
|---|---|---|
| WASHINGTON, ARIELLE N | Treasurer | 2137 SEA PINES WAY, CORAL SPRINGS, FL 33071 |
| Name | Role | Address |
|---|---|---|
| Washington, Gabrielle Vijantimala, MHA | Secretary | 2137 SeaPines Way, Coral Springs, FL 33071 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-03-23 | 3511 NW 8TH AVENUE, 1-2, POMPANO BEACH, FL 33064 | No data |
| AMENDMENT | 2018-02-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-13 | 3511 NW 8TH AVENUE, 1-2, POMPANO BEACH, FL 33064 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-03-20 |
| ANNUAL REPORT | 2020-05-18 |
| ANNUAL REPORT | 2019-03-16 |
| Amendment | 2018-02-20 |
| ANNUAL REPORT | 2018-02-04 |
| ANNUAL REPORT | 2017-04-08 |
| ANNUAL REPORT | 2016-03-24 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
