| Entity Name: | PINELLAS PROFESSIONAL HOME CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Dec 2008 (16 years ago) |
| Document Number: | P08000106223 |
| FEI/EIN Number | 412276049 |
| Address: | 2561 Grand Lakeside DR, Palm Harbor, FL, 34684, US |
| Mail Address: | 2561 Grand Lakeside DR, Palm Harbor, FL, 34684, US |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053619320 | 2011-03-10 | 2011-03-10 | 2075 DUNSTON COVE RD, CLEARWATER, FL, 337551316, US | 2075 DUNSTON COVE RD, CLEARWATER, FL, 337551316, US | |||||||||||||||||||||
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| Phone | +1 727-418-4198 |
| Fax | 7274670923 |
Authorized person
| Name | MR. AMIR MALAK |
| Role | PRESIDENT |
| Phone | 7274184198 |
Taxonomy
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 691579596 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Malak AMIR S | Agent | 2561 Grand Lakeside DR, Palm Harbor, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| Malak Amir S | President | 2561 Grand Lakeside DR, Palm Harbor, FL, 34684 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000117098 | AMIR MALAK NASRALLA HOME MAKER COMPANION SERVICES | ACTIVE | 2010-12-21 | 2026-12-31 | No data | 2075 DUNSTON COVE RD, CLEARWATER, FL, 33755 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-20 | 2561 Grand Lakeside DR, Palm Harbor, FL 34684 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-20 | 2561 Grand Lakeside DR, Palm Harbor, FL 34684 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-20 | 2561 Grand Lakeside DR, Palm Harbor, FL 34684 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-01-25 | Malak, AMIR S | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-02-14 |
| ANNUAL REPORT | 2022-02-11 |
| AMENDED ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-02-10 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-03-08 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
