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AZULLA COMMUNITY HEALTH CENTER, INC. - Florida Company Profile

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Company Details

Entity Name: AZULLA COMMUNITY HEALTH CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 26 May 2016 (9 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 08 Oct 2020 (5 years ago)
Document Number: P16000047065
FEI/EIN Number APPLIED FOR
Address: 2677 Forest Hill Blvd, Unit 125, WEST PALM BEACH, FL, 33406, US
Mail Address: 2677 Forest Hill Blvd, Unit 125, WEST PALM BEACH, FL, 33406, US
ZIP code: 33406
City: West Palm Beach
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HARRIS-VICTOR VENTRICIA President 7455 Fairway Tr, BOCA RATON, FL, 33487
HARRIS-VICTOR VENTRICIA Director 7455 Fairway Tr, BOCA RATON, FL, 33487
HARRIS-VICTOR VENTRICIA Treasurer 7455 Fairway Tr, BOCA RATON, FL, 33487
VICTOR LAGNY P Vice President 7455 Fairway Tr, BOCA RATON, FL, 33487
Victor Lagny V Secretary 101 plaza real s, boca raton, FL, 33432
victor lagny Agent 7455 Fairway Tr, Boca Raton, FL, 33487

National Provider Identifier

NPI Number:
1710748199
Certification Date:
2024-02-05

Authorized Person:

Name:
VENTRICIA HARRIS-VICTOR
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5618558872

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-01-31 2677 Forest Hill Blvd, Unit 125, WEST PALM BEACH, FL 33406 -
CHANGE OF MAILING ADDRESS 2022-01-31 2677 Forest Hill Blvd, Unit 125, WEST PALM BEACH, FL 33406 -
REGISTERED AGENT ADDRESS CHANGED 2022-01-31 7455 Fairway Tr, Boca Raton, FL 33487 -
REGISTERED AGENT NAME CHANGED 2020-10-08 victor, lagny -
REINSTATEMENT 2020-10-08 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 - -
AMENDMENT AND NAME CHANGE 2016-12-08 AZULLA COMMUNITY HEALTH CENTER, INC. -

Documents

Name Date
ANNUAL REPORT 2024-02-29
ANNUAL REPORT 2023-01-20
ANNUAL REPORT 2022-01-31
ANNUAL REPORT 2021-03-18
REINSTATEMENT 2020-10-08
Amendment and Name Change 2016-12-08
Domestic Profit 2016-05-26

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Date of last update: 02 Jul 2025

Sources: Florida Department of State