| Entity Name: | PALM LIFE MEDICAL ASSOCIATES, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Aug 2017 (8 years ago) |
| Document Number: | P17000068345 |
| FEI/EIN Number | 82-2363392 |
| Address: | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258, US |
| Mail Address: | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258, US |
| ZIP code: | 32258 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679092886 | 2017-09-19 | 2017-09-19 | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258, US | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258, US | |||||||||||||||
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| Phone | +1 407-637-7203 |
| Fax | 4076377203 |
Authorized person
| Name | DR. ESAU LAURENCIN |
| Role | PRESIDENT |
| Phone | 4076377203 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LAURENCIN ESAU MD | Agent | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| LAURENCIN ESAU | President | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| LAURENCIN ESAU | Secretary | 12494 ACOSTA OAKS DRIVE, JACKSONVILLE, FL, 32258 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-03-26 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-07-25 |
| ANNUAL REPORT | 2020-06-28 |
| ANNUAL REPORT | 2019-03-06 |
| ANNUAL REPORT | 2018-03-18 |
| Domestic Profit | 2017-08-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
