| Entity Name: | TITAN HEALTH TEAM, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 24 Jan 2018 (7 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P18000007595 |
| Address: | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| Mail Address: | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| ZIP code: | 33436 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457852840 | 2018-02-22 | 2018-02-22 | 4 WESTGATE LN APT C, BOYNTON BEACH, FL, 334366358, US | 4 WESTGATE LN APT C, BOYNTON BEACH, FL, 334366358, US | |||||||||||||||||||||||||
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| Phone | +1 516-224-4157 |
| Fax | 5168644599 |
Authorized person
| Name | DR. DENISE C SANTUCCI |
| Role | PRESIDENT |
| Phone | 5162244157 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 225164 |
| State | NY |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 02365837 |
| State | NY |
| Name | Role | Address |
|---|---|---|
| SANTUCCI, DENISE | Agent | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| Name | Role | Address |
|---|---|---|
| SANTUCCI, DENISE C | President | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| Name | Role | Address |
|---|---|---|
| SANTUCCI, DENISE C | Secretary | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| Name | Role | Address |
|---|---|---|
| SANTUCCI, DENISE C | Treasurer | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| Name | Role | Address |
|---|---|---|
| SANTUCCI, DENISE C | Director | 4 C. WESTGATE LANE, BOYNTON BEACH, FL 33436 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2018-01-24 |
Date of last update: 17 Feb 2025
Sources: Florida Department of State
