| Entity Name: | SOMA MEDICAL CENTER, P.A. #4 |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Dec 2010 (14 years ago) |
| Document Number: | P10000102755 |
| FEI/EIN Number | 27-4373735 |
| Address: | 421 SOUTH DIXIE HWAY, LAKE WORTH, FL, 33460, US |
| Mail Address: | 330 S. DIXIE HWY., STE. 3 & 4, LAKE WORTH, FL, 33460, US |
| ZIP code: | 33460 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942770912 | 2018-12-03 | 2021-04-02 | 10125 W COLONIAL DR STE 204, OCOEE, FL, 347614200, US | 10125 W COLONIAL DR STE 204, OCOEE, FL, 347614200, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 561-275-1155 |
| Fax | 5612757151 |
| Phone | +1 561-281-4707 |
Authorized person
| Name | PAOLA A ALOMIA |
| Role | ASSISTANCE PRACTICE ADM |
| Phone | 5612751155 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FLOREZ-NUNEZ JACQUELINE | Agent | 330 S. DIXIE HWY., LAKE WORTH, FL, 33460 |
| Name | Role | Address |
|---|---|---|
| NUNEZ RAFAEL | Vice President | 13628 QUARTER HORSE TRAIL, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| FOREZ-NUNEZ JACQUELINE | President | 13628 QUARTER HORSE TRAIL, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| NUNEZ JACQUELINE | SECF | 421 SOUTH DIXIE HWAY, LAKE WORTH, FL, 33460 |
| Name | Role | Address |
|---|---|---|
| NUNEZ CATALINA | Chief Financial Officer | 3255 FOREST HILL BLVD STE 103, WEST PALM BEACH, FL, 33406 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-13 | 421 SOUTH DIXIE HWAY, LAKE WORTH, FL 33460 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-18 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-13 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-03-01 |
| ANNUAL REPORT | 2018-01-29 |
| ANNUAL REPORT | 2017-03-28 |
| ANNUAL REPORT | 2016-02-02 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
