| Entity Name: | MOBILE MEDICAL CARE OF THE PALM BEACHES PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Dec 2019 (5 years ago) |
| Document Number: | P19000092624 |
| FEI/EIN Number | 84-4008790 |
| Address: | 280 Sawgrass Drive, Yulee, FL, 32097, US |
| Mail Address: | 280 Sawgrass Drive, Yulee, FL, 32097, US |
| ZIP code: | 32097 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366082620 | 2020-01-14 | 2020-01-14 | 1600 S FEDERAL HWY STE 420, POMPANO BEACH, FL, 330627531, US | 1600 S FEDERAL HWY STE 420, POMPANO BEACH, FL, 330627531, US | |||||||||||||||||
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| Phone | +1 561-410-0242 |
Authorized person
| Name | LAWRENCE SMITH |
| Role | D.O. OWNER |
| Phone | 5614100242 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| YARBROUGH TIMOTHY MAPRN | Agent | 280 Sawgrass Drive, Yulee, FL, 32097 |
| Name | Role | Address |
|---|---|---|
| YARBROUGH TIMOTHY APRN | Director | 280 Sawgrass Drive, Yulee, FL, 32097 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-05 | 280 Sawgrass Drive, Yulee, FL 32097 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-05 | 280 Sawgrass Drive, Yulee, FL 32097 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-05 | 280 Sawgrass Drive, Yulee, FL 32097 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-05-17 | YARBROUGH, TIMOTHY M, APRN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2023-02-17 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-05-17 |
| Domestic Profit | 2019-12-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
