| Entity Name: | COLES HEALTHCARE SERVICES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Apr 2012 (13 years ago) |
| Document Number: | P12000031961 |
| FEI/EIN Number | 45-4991574 |
| Address: | 3898 West Commercial Blvd, Tamarac, FL, 33309, US |
| Mail Address: | 3898 West Commercial Blvd, Tamarac, FL, 33309, US |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205295821 | 2016-02-11 | 2016-02-11 | 7961 NW 4TH PL, PLANTATION, FL, 333241950, US | 3898 W COMMERCIAL BLVD, TAMARAC, FL, 333093326, US | |||||||||||||||||||||||||||||||
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| Phone | +1 754-444-8826 |
| Fax | 9548562921 |
Authorized person
| Name | MR. DONALD COLES |
| Role | PRESIDENT |
| Phone | 9545935524 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | AP1506 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | PA9104805 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | B2150Y |
| Name | Role | Address |
|---|---|---|
| COLES DONALD | Agent | 3898 West Commercial Blvd, Tamarac, FL, 33309 |
| Name | Role | Address |
|---|---|---|
| COLES DONALD | President | 3898 West Commercial Blvd, Tamarac, FL, 33309 |
| Name | Role | Address |
|---|---|---|
| COLES JUANA A | Vice President | 3898 West Commercial Blvd, Tamarac, FL, 33309 |
| Name | Role | Address |
|---|---|---|
| Jean-Baptiste Marc H | Owne | 3898 West Commercial Blvd, Tamarac, FL, 33309 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000109518 | TRADITIONAL MEDICINE CENTER | ACTIVE | 2015-10-27 | 2025-12-31 | No data | 3898 W. COMMERCIAL BLVD, TAMARAC, FL, 33309 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-05-01 | 3898 West Commercial Blvd, Tamarac, FL 33309 | No data |
| CHANGE OF MAILING ADDRESS | 2016-05-01 | 3898 West Commercial Blvd, Tamarac, FL 33309 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-05-01 | 3898 West Commercial Blvd, Tamarac, FL 33309 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-09-19 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-04-06 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-06-13 |
| AMENDED ANNUAL REPORT | 2016-05-30 |
| ANNUAL REPORT | 2016-05-01 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8934958505 | 2021-03-10 | 0455 | PPS | 3898 W Commercial Blvd, Tamarac, FL, 33309-3326 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5878007300 | 2020-04-30 | 0455 | PPP | 3898 W COMMERCIAL BLVD, TAMARAC, FL, 33309-3326 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
