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JACOB A MARDER, DNP PA - Florida Company Profile

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Company Details

Entity Name: JACOB A MARDER, DNP PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 07 Mar 2023 (2 years ago)
Document Number: P23000019509
FEI/EIN Number 922914119
Address: 1411 North Flagler Drive, West Palm Beach, FL, 33401, US
Mail Address: 1 Ocean Lane, PALM BEACH, FL, 33480, US
ZIP code: 33401
City: West Palm Beach
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
MARDER JACOB A President 1411 North Flagler Drive, West Palm Beach, FL, 33401
MARDER JACOB A Agent 1411 North Flagler Drive, West Palm Beach, FL, 33401

National Provider Identifier

NPI Number:
1790489524
Certification Date:
2025-03-23

Authorized Person:

Name:
DR. JACOB ARIEL MARDER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
5619355537

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000036878 FLAGLER DERMATOLOGY ACTIVE 2023-03-21 2028-12-31 - 1411 NORTH FLAGLER DRIVE, SUITE 9000, WEST PALM BEACH, FL, 33401

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-24 1411 North Flagler Drive, Suite 9000, West Palm Beach, FL 33401 -
REGISTERED AGENT ADDRESS CHANGED 2024-03-24 1 Ocean Lane, PALM BEACH, FL 33480 -
CHANGE OF MAILING ADDRESS 2023-08-21 1411 North Flagler Drive, Suite 9000, West Palm Beach, FL 33401 -

Documents

Name Date
ANNUAL REPORT 2024-03-24
Domestic Profit 2023-03-07

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Date of last update: 03 Aug 2025

Sources: Florida Department of State