| Entity Name: | EXCEPTIONAL PEDIATRIC HEALTH CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 May 2024 (8 months ago) |
| Document Number: | P24000036993 |
| Address: | 401 E.LAS OLAS BLVD, 1400, FORT LAUDERLADE, FL, 33301 |
| Mail Address: | 401 E.LAS OLAS BLVD, 1400, FORT LAUDERLADE, FL, 33301 |
| ZIP code: | 33301 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114763497 | 2024-07-05 | 2024-07-05 | 401 E LAS OLAS BLVD STE 1400, FORT LAUDERDALE, FL, 333012218, US | 401 E LAS OLAS BLVD STE 1400, FORT LAUDERDALE, FL, 333012218, US | |||||||||||||
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| Phone | +1 786-320-2768 |
Authorized person
| Name | LUDMILA VILLALOBOS |
| Role | AUTHORIZED OFFICIAL |
| Phone | 7863202768 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VILLALOBOS LUDMILA | Agent | 401 E.LAS OLAS BLVD, FORT LAUDERLADE, FL, 33301 |
| Name | Role | Address |
|---|---|---|
| VILLALOBOS LUDMILA | President | 401 E.LAS OLAS BLVD SUITE 1400, FORT LAUDERLADE, FL, 33301 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-05-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
