| Entity Name: | NADIA PIERRE MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Mar 2016 (9 years ago) |
| Document Number: | P16000023426 |
| FEI/EIN Number | 81-1776995 |
| Address: | 12983 SOUTHERN BLVD, 201, LOXAHATCHEE, FL, 33470, US |
| Mail Address: | 9314 FOREST HILL BLVD, SUITE 34, WELLINGTON, FL, 33411, US |
| ZIP code: | 33470 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962858308 | 2016-05-04 | 2016-09-16 | 12983 SOUTHERN BLVD, SUITE 201, LOXAHATCHEE, FL, 334709207, US | 12983 SOUTHERN BLVD, SUITE 201, LOXAHATCHEE, FL, 334709207, US | |||||||||||||||||||||||
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| Phone | +1 561-791-2888 |
| Fax | 5614917447 |
Authorized person
| Name | NADIA PIERRE |
| Role | AUTHORIZED REP/OWNER |
| Phone | 5617912888 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 017350600 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NADIA PIERRE MD 401K | 2023 | 811776995 | 2024-09-05 | NADIA PIERRE MD PA | 2 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-05 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8134864132 |
| Plan sponsor’s address | 12983 SOUTHERN BLVD, STE 201, LOXAHATCHEE, FL, 33470 |
Signature of
| Role | Plan administrator |
| Date | 2023-08-15 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| PIERRE NADIA | Agent | 12983 SOUTHERN BLVD, STE. 201, LOXAHATCHEE, FL, 33470 |
| Name | Role | Address |
|---|---|---|
| PIERRE NADIA | President | 12983 SOUTHERN BLVD.,, LOXAHATCHEE, FL, 33470 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000028146 | PREMIER OBSTETRICS AND GYNECOLOGY OF PALM BEACH | EXPIRED | 2016-03-16 | 2021-12-31 | No data | 9314 FOREST HILL BLVD, SUITE 34, WELLINGTON, FL, 33411 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2016-09-06 | 12983 SOUTHERN BLVD, STE. 201, LOXAHATCHEE, FL 33470 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-02-12 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-02-07 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-02-16 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-02-11 |
| Reg. Agent Change | 2016-09-06 |
| Off/Dir Resignation | 2016-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
