| Entity Name: | PAHOKEE HEALTHCARE INCORPORATED |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Aug 2015 (9 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P15000067908 |
| FEI/EIN Number | APPLIED FOR |
| Mail Address: | 7657 LAKE WORTH ROAD, LAKE WORTH, FL, 33467 |
| Address: | 170 BARFILED HWY, 102, PAHOKEE, FL, 33476 |
| ZIP code: | 33476 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013383595 | 2015-08-19 | 2015-09-01 | 7657 LAKE WORTH RD, LAKE WORTH, FL, 334672534, US | 170 BARFIELD HIGHWAY, SUITE 104, PAHOKEE, FL, 33476, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-432-4141 |
| Fax | 5614324166 |
Authorized person
| Name | MONIQUE BARBOUR |
| Role | PRESIDENT |
| Phone | 5619067292 |
Taxonomy
| Taxonomy Code | 122300000X - Dentist |
| License Number | DN0013708 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | No |
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME68835 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00967800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BARBOUR MONIQUE M | Agent | 7657 LAKE WORTH ROAD, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| BARBOUR MONIQUE M | President | 7657 LAKE WORTH ROAD, LAKE WORTH, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-27 |
| Domestic Profit | 2015-08-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
