| Entity Name: | DIANA HEALTH FL P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Nov 2023 (a year ago) |
| Document Number: | P23000079613 |
| FEI/EIN Number | 994489868 |
| Address: | 1046 Mar-Walt Drive, Suite 200, Fort Walton Beach, FL, 32547, US |
| Mail Address: | 178 COLUMBUS AVE, UNIT 237190 #33783 SMB, NEW YORK, NY, 10023, US |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194591966 | 2023-12-01 | 2024-07-11 | 178 COLUMBUS AVE, #237190 SMB#33783, NEW YORK, NY, 10023, US | 1046 MAR WALT DR, SUITE 200, FORT WALTON BEACH, FL, 32547, US | |||||||||||||
|
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| Phone | +1 850-243-2229 |
Authorized person
| Name | GABRIELLE FERNANDOPULLE |
| Role | OPERATIONS MANAGER |
| Phone | 6174606978 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| CONDLIFFE KATE | President | 4 Lefurgy Terrace, Hastings on Hudson, NY, 10706 |
| Name | Role | Address |
|---|---|---|
| Shawn Ramsey Shawn | Officer | 1046 Mar-Walt Drive, Fort Walton Beach, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-20 | 1046 Mar-Walt Drive, Suite 200, Fort Walton Beach, FL 32547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-20 |
| Domestic Profit | 2023-11-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
