| Entity Name: | JACOB A MARDER, DNP PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 07 Mar 2023 (2 years ago) |
| Document Number: | P23000019509 |
| FEI/EIN Number | 92-2914119 |
| Address: | 1411 North Flagler Drive, Suite 9000, West Palm Beach, FL 33401 |
| Mail Address: | 1 Ocean Lane, PALM BEACH, FL 33480 |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790489524 | 2023-03-27 | 2024-08-06 | 1 OCEAN LN, PALM BEACH, FL, 334803304, US | 1411 N FLAGLER DR STE 9000, WEST PALM BEACH, FL, 334013421, US | |||||||||||||||||||
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| Phone | +1 561-584-8460 |
| Fax | 5619355537 |
Authorized person
| Name | DR. JACOB ARIEL MARDER |
| Role | CEO |
| Phone | 5615848460 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MARDER, JACOB A | Agent | 1 Ocean Lane, PALM BEACH, FL 33480 |
| Name | Role | Address |
|---|---|---|
| MARDER, JACOB A | President | 1 ocean Lane, Palm Beach, FL 33480 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000036878 | FLAGLER DERMATOLOGY | ACTIVE | 2023-03-21 | 2028-12-31 | No data | 1411 NORTH FLAGLER DRIVE, SUITE 9000, WEST PALM BEACH, FL, 33401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-24 | 1411 North Flagler Drive, Suite 9000, West Palm Beach, FL 33401 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-24 | 1 Ocean Lane, PALM BEACH, FL 33480 | No data |
| CHANGE OF MAILING ADDRESS | 2023-08-21 | 1411 North Flagler Drive, Suite 9000, West Palm Beach, FL 33401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| Domestic Profit | 2023-03-07 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
