| Entity Name: | PALM BEACH PALLIATIVE CARE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 12 Feb 2021 (4 years ago) |
| Document Number: | P21000016053 |
| FEI/EIN Number | 86-2042519 |
| Address: | 1240 NW 8TH STREET, BOCA RATON, FL 33486 |
| Mail Address: | 1240 NW 8TH STREET, BOCA RATON, FL 33486 |
| ZIP code: | 33486 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407420383 | 2021-05-17 | 2023-07-20 | PO BOX 273776, BOCA RATON, FL, 334273776, US | 1240 NW 8TH ST, BOCA RATON, FL, 334862102, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 561-620-3025 |
| Fax | 5616092553 |
Authorized person
| Name | ROSE-LAURE MOUSSIGNAC |
| Role | OWNER |
| Phone | 5616203025 |
Taxonomy
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PALM BEACH PALLIATIVE CARE 401(K) PLAN | 2023 | 862042519 | 2024-06-05 | PALM BEACH PALLIATIVE CARE, PA | 3 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-06-05 |
| Name of individual signing | KELLY DURANTE |
| 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 | 7866951915 |
| Plan sponsor’s address | 1240 NW 8TH STREET, BOCA RATON, FL, 33486 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-15 |
| Name of individual signing | KELLY DURANTE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| PARLADE, JAIME | Agent | 5975 SUNSET DRIVE, 802, SOUTH MIAMI, FL 33143 |
| Name | Role | Address |
|---|---|---|
| MOUSSIGNAC, ROSE LAURE | President | 1240 NW 8TH STREET, BOCA RATON, FL 33486 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-09 |
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-07 |
| Domestic Profit | 2021-02-12 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
