| Entity Name: | ST. JUDE PROFESSIONAL CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Jan 2011 (14 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Oct 2022 (2 years ago) |
| Document Number: | P11000000933 |
| FEI/EIN Number | 27-4503894 |
| Address: | 11603 NW 89th Street, # 104, DORAL, FL, 33178, US |
| Mail Address: | 100 NW 170 ST, STE 105, NORTH MIAMI BEACH, FL, 33169, US |
| ZIP code: | 33178 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558743666 | 2015-06-25 | 2016-02-18 | 9806 PINES BLVD, PEMBROKE PINES, FL, 330246141, US | 9806 PINES BLVD, PEMBROKE PINES, FL, 330246141, US | |||||||||||||||||||
|
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| Phone | +1 786-663-6394 |
| Fax | 9543675246 |
Authorized person
| Name | NICOLE NICODEMO |
| Role | OWNER |
| Phone | 7866636394 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | PT25877 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NICODEMO NICOLE R | Agent | 12049 Pioneers Way, Orlando, FL, 32832 |
| Name | Role | Address |
|---|---|---|
| NICODEMO NICOLE R | President | 11603 NW 89TH ST, DORAL, FL, 33178 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-14 | 12049 Pioneers Way, 2242, Orlando, FL 32832 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-11-18 | 11603 NW 89th Street, # 104, DORAL, FL 33178 | No data |
| CHANGE OF MAILING ADDRESS | 2022-11-15 | 11603 NW 89th Street, # 104, DORAL, FL 33178 | No data |
| REINSTATEMENT | 2022-10-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| AMENDMENT | 2021-10-15 | No data | No data |
| REINSTATEMENT | 2021-10-06 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-10-06 | NICODEMO, NICOLE R | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| AMENDMENT | 2017-05-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-14 |
| ANNUAL REPORT | 2023-04-22 |
| REINSTATEMENT | 2022-10-17 |
| Amendment | 2021-10-15 |
| REINSTATEMENT | 2021-10-06 |
| Amendment | 2017-05-22 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-01-30 |
| Amendment | 2015-06-08 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
