| Entity Name: | ROSSANA MOURA, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 24 Jan 2008 (17 years ago) |
| Document Number: | P08000008716 |
| FEI/EIN Number | 26-1782202 |
| Address: | 1601 N. PALM AVE, SUITE 311, PEMBROKE PINES, FL 33026 |
| Mail Address: | 1601 N. PALM AVE, SUITE 311, PEMBROKE PINES, FL 33026 |
| ZIP code: | 33026 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821269846 | 2008-03-18 | 2022-04-20 | 1601 N PALM AVE STE 311, PEMBROKE PINES, FL, 330263242, US | 1601 N PALM AVE STE 311, PEMBROKE PINES, FL, 330263242, US | |||||||||||||||||||||||||
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| Phone | +1 954-874-9000 |
| Fax | 9548747901 |
Authorized person
| Name | DR. ROSSANA MOURA |
| Role | AUTHORIZED OFFICIAL |
| Phone | 9548749000 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| License Number | ME79901 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | ME79901 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DIFIORE, CHRISTINE MCPA | Agent | 14201 W. SUNRISE BLVD, SUITE 201, SUNRISE, FL 33323 |
| Name | Role | Address |
|---|---|---|
| MOURA, ROSSANA MD | President | 1601 N. PALM AVE, SUITE 311 PEMBROKE PINES, FL 33026 |
| Name | Role | Address |
|---|---|---|
| MOURA, ROSSANA MD | Director | 1601 N. PALM AVE, SUITE 311 PEMBROKE PINES, FL 33026 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-29 | 1601 N. PALM AVE, SUITE 311, PEMBROKE PINES, FL 33026 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-29 | 1601 N. PALM AVE, SUITE 311, PEMBROKE PINES, FL 33026 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-02-08 | DIFIORE, CHRISTINE MCPA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-02-08 | 14201 W. SUNRISE BLVD, SUITE 201, SUNRISE, FL 33323 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-25 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-01-29 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-03-23 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
