| Entity Name: | SOMA MEDICAL CENTER PA 11 |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 11 Sep 2023 (a year ago) |
| Document Number: | P23000065560 |
| FEI/EIN Number | 93-3336412 |
| Mail Address: | 3255 FOREST HILL BLVD, STE 103, PALM SPRINGS, FL 33406 |
| Address: | 1402 ROYAL PALM BEACH BLVD, SUITE 700, ROYAL PALM BEACH, FL 33411 |
| ZIP code: | 33411 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780461046 | 2023-09-11 | 2023-09-11 | 1402 ROYAL PALM BEACH BLVD STE 700, ROYAL PALM BEACH, FL, 334111699, US | 1402 ROYAL PALM BEACH BLVD STE 700, ROYAL PALM BEACH, FL, 334111699, US | |||||||||||||||
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| Phone | +1 561-650-5636 |
| Fax | 5617202528 |
Authorized person
| Name | DR. RAFAEL O NUNEZ |
| Role | OWNER |
| Phone | 5619644577 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FLOREZ-NUNEZ, JACQUELINE | Agent | 13628 QUARTER HORSE TRAIL, WELLINGTON, FL 33414 |
| Name | Role | Address |
|---|---|---|
| FLOREZ-NUNEZ, JACQUELINE | President | 3255 FOREST HILL BLVD, STE 103 PALM SPRINGS, FL 33406 |
| Name | Role | Address |
|---|---|---|
| NUNEZ, RAFAEL | Vice President | 3255 FOREST HILL BLVD, STE 103 PALM SPRINGS, FL 33406 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-22 | 1402 ROYAL PALM BEACH BLVD, SUITE 700, ROYAL PALM BEACH, FL 33411 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-22 |
| ANNUAL REPORT | 2024-01-27 |
| Domestic Profit | 2023-09-11 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
