| Entity Name: | PEMBROKE VILLAGE MEDICAL CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PEMBROKE VILLAGE MEDICAL CENTER, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 13 Jan 2009 (16 years ago) |
| Date of dissolution: | 23 Sep 2022 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (3 years ago) |
| Document Number: | P09000003588 |
| FEI/EIN Number |
264037880
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 13550 S.W. 10TH STREET, SUITE B, PEMBROKE PINES, FL, 33027 |
| Mail Address: | 1090 JUPITER PARK DR, SUITE 101, JUPITER, FL, 33458, US |
| ZIP code: | 33027 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235378837 | 2009-02-05 | 2014-12-29 | 250 S. CENTRAL BLVD, SUITE 207, JUPITER, FL, 33458, US | 13550 SW 10TH ST, PEMBROKE PINES, FL, 330276445, US | |||||||||||||||||||||||||
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| Phone | +1 561-745-3877 |
| Fax | 5617453866 |
| Phone | +1 954-435-6001 |
| Fax | 9544356137 |
Authorized person
| Name | ROBERT D CAMERLINCK |
| Role | PRESIDENT |
| Phone | 5617453877 |
Taxonomy
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | DA777A |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BANSAL RAJENDRA M | President | 875 N. MILITARY TRAIL, # 200, JUPITER, FL, 33458 |
| BANSAL RAJENDRA M | Secretary | 875 N. MILITARY TRAIL, # 200, JUPITER, FL, 33458 |
| BANSAL RAJENDRA M | Treasurer | 875 N. MILITARY TRAIL, # 200, JUPITER, FL, 33458 |
| BANSAL RAJENDRA M | Director | 875 N. MILITARY TRAIL, # 200, JUPITER, FL, 33458 |
| CAMERLINCK ROBERT D | Manager | 1090 JUPITER PARK DR, JUPITER, FL, 33458 |
| DANIELS ALYS N | Agent | 701 US HIGHWAY ONE, NORTH PALM BEACH, FL, 33408 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000010413 | CENTRAL VILLAGE MEDICAL CENTER | EXPIRED | 2016-01-28 | 2021-12-31 | - | 1090 JUPITER PARK DRIVE, SUITE 101, JUPITER, FL, 33458 |
| G15000069284 | CENTRAL VILLAGE MEDICAL CENTER | ACTIVE | 2015-07-02 | 2025-12-31 | - | 1090 JUPITER PARK DR, SUITE 201, JUPITER, FL, 33458 |
| G09079900060 | CENTURY VILLAGE MEDICAL CENTER | EXPIRED | 2009-03-20 | 2014-12-31 | - | PEMBROKE VILLAGE MEDICAL CENTER, INC., 250 S. CENTRAL BLVD. #207, JUPITER, FL, 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | - | - |
| CHANGE OF MAILING ADDRESS | 2020-06-29 | 13550 S.W. 10TH STREET, SUITE B, PEMBROKE PINES, FL 33027 | - |
| REGISTERED AGENT NAME CHANGED | 2020-06-29 | DANIELS, ALYS N | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-29 | 701 US HIGHWAY ONE, SUITE 402, NORTH PALM BEACH, FL 33408 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-11 | 13550 S.W. 10TH STREET, SUITE B, PEMBROKE PINES, FL 33027 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-01-23 |
| ANNUAL REPORT | 2016-02-09 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-21 |
| ANNUAL REPORT | 2013-04-10 |
| ANNUAL REPORT | 2012-03-28 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
