| Entity Name: | PROVIDERS HEALTH ALLIANCE 004 MM, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Mar 2023 (2 years ago) |
| Document Number: | P23000022410 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 8188 S JOG RD, STE 205, BOYNTON BEACH, FL, 33472-2952 |
| Mail Address: | 11924 FOREST HILL BLVD, STE 10A-413, WELLINGTON, FL, 33414 |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| ANDERS CHERYL | Agent | 11924 FOREST HILL BLVD, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| MORA MELISSA | President | 8188 S JOG RD STE 205, BOYNTON BEACH, FL, 334722952 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| Domestic Profit | 2023-03-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
