| Entity Name: | PRIORITY HEALTH MD INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Dec 2021 (3 years ago) |
| Document Number: | P22000000945 |
| FEI/EIN Number | 87-4138525 |
| Address: | 9999 Sheridan Street, Cooper City, FL, 33024, US |
| Mail Address: | 9999 Sheridan Street, Cooper City, FL, 33024, US |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891447694 | 2022-01-23 | 2022-12-13 | 4765 SW 148TH AVE, DAVIE, FL, 333302127, US | 9999 SHERIDAN ST STE 120, HOLLYWOOD, FL, 330243086, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 954-374-7545 |
| Phone | +1 954-589-1198 |
Authorized person
| Name | DR. ROBERTO FERNANDEZ-BLAY |
| Role | DIRECTOR |
| Phone | 9548902524 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Fernandez-Blay Roberto | Agent | 9999 Sheridan Street, Cooper City, FL, 33024 |
| Name | Role | Address |
|---|---|---|
| FERNANDEZ-BLAY ROBERTO | President | 9999 Sheridan Street, Cooper City, FL, 33024 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-19 | 9999 Sheridan Street, Suite 120, Cooper City, FL 33024 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-19 | 9999 Sheridan Street, Suite 120, Cooper City, FL 33024 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-19 | Fernandez-Blay, Roberto | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-19 | 9999 Sheridan Street, Suite 120, Cooper City, FL 33024 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-04-13 |
| Domestic Profit | 2021-12-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
