| Entity Name: | SOMA MEDICAL CENTER PA #5 |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 31 Jan 2013 (12 years ago) |
| Document Number: | P13000010587 |
| FEI/EIN Number | 46-1945862 |
| Mail Address: | 3255 FOREST HILL BLVD, SUITE 103, WEST PALM BEACH, FL 33406 |
| Address: | 330 SOUTH DIXIE HWY, LAKE WORTH, FL 33460 |
| ZIP code: | 33460 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063754588 | 2013-03-22 | 2023-09-26 | 330 S DIXIE HWY, LAKE WORTH, FL, 334604400, US | 330 S DIXIE HWY, LAKE WORTH, FL, 334604400, US | |||||||||||||||||||
|
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| Phone | +1 561-227-3993 |
| Fax | 5618554308 |
Authorized person
| Name | DR. RAFAEL O NUNEZ |
| Role | MEDICAL DIRECTOR |
| Phone | 5619644577 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NUNEZ, RAFAEL | Agent | 3255 FOREST HILL BLVD, 103, WEST PALM BEACH, FL 33406 |
| Name | Role | Address |
|---|---|---|
| NUNEZ, RAFAEL | President | 3255 FOREST HILL BLVD, SUITE 103 WEST PALM BEACH, FL 33406 |
| Name | Role | Address |
|---|---|---|
| NUNEZ, JACQUELINE | Secretary | 3255 FOREST HILL BLVD, SUITE 103 WEST PALM BEACH, FL 33406 |
| 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 MAILING ADDRESS | 2025-01-21 | 330 SOUTH DIXIE HWY, LAKE WORTH, FL 33460 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-12-19 | 330 SOUTH DIXIE HWY, LAKE WORTH, FL 33460 | No data |
| CHANGE OF MAILING ADDRESS | 2024-12-19 | 330 SOUTH DIXIE HWY, LAKE WORTH, FL 33460 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-13 | 3255 FOREST HILL BLVD, 103, WEST PALM BEACH, FL 33406 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-13 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-03-10 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-02-02 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
