| Entity Name: | MOBILE MEDICS ANCILLARY SERVICES, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Jul 2009 (16 years ago) |
| Document Number: | P09000059279 |
| FEI/EIN Number | 270538644 |
| Address: | 10423 S Barnsley dr, PARKLAND, FL, 33076, US |
| Mail Address: | 10423 S Barnsley dr, PARKLAND, FL, 33076, US |
| ZIP code: | 33076 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417187261 | 2009-07-15 | 2020-08-16 | 10423 S BARNSLEY DR, PARKLAND, FL, 330764471, US | 10423 S BARNSLEY DR, PARKLAND, FL, 330764471, US | |||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 954-562-5855 |
| Fax | 9547750019 |
Authorized person
| Name | MUKESH WADHWA |
| Role | OFFICE DIRECTOR |
| Phone | 9545625855 |
Taxonomy
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | 14086 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | 9165576 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | Y03VK |
| State | FL |
| Issuer | AETNA |
| Number | 9239596 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANIAR RAJU | Agent | 1401 N UNIVERSITY DR, CORAL SPRINGS, FL, 33071 |
| Name | Role | Address |
|---|---|---|
| WADHWA MUKESH | Officer | 10423 S Barnsley dr, PARKLAND, FL, 33076 |
| WADHWA BHARTI | Officer | 10423 S Barnsley dr, PARKLAND, FL, 33076 |
| Name | Role | Address |
|---|---|---|
| WADHWA MUKESH | Director | 10423 S Barnsley dr, PARKLAND, FL, 33076 |
| WADHWA BHARTI | Director | 10423 S Barnsley dr, PARKLAND, FL, 33076 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-20 | 1401 N UNIVERSITY DR, #301B, CORAL SPRINGS, FL 33071 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-22 | 10423 S Barnsley dr, PARKLAND, FL 33076 | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-22 | 10423 S Barnsley dr, PARKLAND, FL 33076 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-17 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-02-21 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-02-25 |
| ANNUAL REPORT | 2019-03-20 |
| ANNUAL REPORT | 2018-02-26 |
| ANNUAL REPORT | 2017-01-22 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-01-17 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
