| Entity Name: | SOMA MEDICAL CENTER PA 14 |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Sep 2023 (a year ago) |
| Document Number: | P23000067953 |
| FEI/EIN Number | 93-3522033 |
| Address: | 3145 SOUTH CONGRESS AVENUE, PALM SPRINGS, FL, 33461, US |
| Mail Address: | 3255 FOREST HILL BLVD, STE 103, WEST PALM BEACH, FL, 33406, US |
| ZIP code: | 33461 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558140384 | 2023-09-21 | 2023-09-21 | 3129 S CONGRESS AVE, PALM SPRINGS, FL, 334612551, US | 3129 S CONGRESS AVE, PALM SPRINGS, FL, 334612551, US | |||||||||||||
|
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| Phone | +1 561-964-4577 |
Authorized person
| Name | DR. RAFAEL O NUNEZ |
| Role | PRESIDENT, MEDICAL DIRECTOR |
| Phone | 5619644577 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine 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 | 13628 QUARTER HORSE TRAIL, WELLINGTON, FL, 33414 |
| Name | Role | Address |
|---|---|---|
| NUNEZ RAFAEL | Vice President | 13628 QUARTER HORSE TRAIL, WELLINGTON, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-11-28 | 3145 SOUTH CONGRESS AVENUE, Suite A, PALM SPRINGS, FL 33461 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-18 |
| Domestic Profit | 2023-09-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
