| Entity Name: | TOTAL FAMILY HEALTH CARE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Jun 2008 (17 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2020 (4 years ago) |
| Document Number: | P08000054428 |
| FEI/EIN Number | 262735400 |
| Address: | 7800 W OAKLAND PARK BLVD, Ste 214, Sunrise, FL, 33351, US |
| Mail Address: | PO BOX 16472, PLANTATION, FL, 33318-6472, US |
| ZIP code: | 33351 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1174775662 | 2008-10-16 | 2023-07-05 | PO BOX 16472, FT LAUDERDALE, FL, 333186472, US | 7800 W OAKLAND PARK BLVD STE 214, SUNRISE, FL, 333511126, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-778-3157 |
| Fax | 8885382226 |
| Phone | +1 954-431-7676 |
Authorized person
| Name | MRS. MARJORIE M GILLESPIE |
| Role | PRESIDENT |
| Phone | 9544317676 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103TP0016X - Prescribing (Medical) Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TP2701X - Group Psychotherapy Psychologist |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | 2809552 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 301733800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 100365400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GILLESPIE MARJORIE | Agent | 7800 W OAKLAND PARK BLVD, Sunrise, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| GILLESPIE MARJORIE | President | PO BOX 16472, PLANTATION, FL, 333186472 |
| Name | Role | Address |
|---|---|---|
| BERNARD KADIAN A | Secretary | 741 Gardenia Lane, PLANTATION, FL, 333171913 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-07 | 7800 W OAKLAND PARK BLVD, Ste 214, BLDG E, Sunrise, FL 33351 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-07 | 7800 W OAKLAND PARK BLVD, Ste 214, BLDG E, Sunrise, FL 33351 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-07 | 7800 W OAKLAND PARK BLVD, Ste 214, BLDG E, Sunrise, FL 33351 | No data |
| REINSTATEMENT | 2020-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REINSTATEMENT | 2019-02-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-08-30 | GILLESPIE , MARJORIE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| AMENDED ANNUAL REPORT | 2023-02-26 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-03-22 |
| ANNUAL REPORT | 2021-04-30 |
| REINSTATEMENT | 2020-09-30 |
| REINSTATEMENT | 2019-02-15 |
| ANNUAL REPORT | 2017-07-12 |
| ANNUAL REPORT | 2016-08-30 |
| ANNUAL REPORT | 2015-04-25 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
