| Entity Name: | PRIMARY CARE MEDICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 18 Jun 1998 (27 years ago) |
| Date of dissolution: | 16 Apr 2013 (12 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 16 Apr 2013 (12 years ago) |
| Document Number: | P98000054987 |
| FEI/EIN Number | 650840716 |
| Address: | 830 NW 115TH AVE, PLANTATION, FL, 33325 |
| Mail Address: | 830 NW 115TH AVE, PLANTATION, FL, 33325 |
| ZIP code: | 33325 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750418299 | 2007-02-28 | 2020-08-22 | PO BOX 848127, PEMBROKE PINES, FL, 330840127, US | 10000 STIRLING RD, SUITE 3, HOLLYWOOD, FL, 330248067, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 954-517-9166 |
| Fax | 9545179167 |
Authorized person
| Name | DR. MARIE-ALICE LARA |
| Role | VICE PRESIDENTD |
| Phone | 9545179166 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME69293 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME79139 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 74888 |
| State | FL |
| Name | Role |
|---|---|
| LEGAGNEUR & ASSOCIATES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| LARA MARIE-ALICE MD | Director | 8702 BLAZE CT, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| LARA MARIE-ALICE MD | President | 8702 BLAZE CT, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| JEAN-BAPTISTE MARC HMD | Vice President | 8702 BLAZE CT, DAVIE, FL, 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-16 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-26 | 830 NW 115TH AVE, PLANTATION, FL 33325 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-26 | 830 NW 115TH AVE, PLANTATION, FL 33325 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-17 | 19545 SEDGEFIELD TERR, BOCA RATON, FL 33498 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-04-17 | LEGAGNEUR & ASSOCIATES | No data |
| REINSTATEMENT | 1999-12-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-16 |
| ANNUAL REPORT | 2012-04-26 |
| ANNUAL REPORT | 2011-04-05 |
| ANNUAL REPORT | 2010-04-17 |
| ANNUAL REPORT | 2009-04-08 |
| ANNUAL REPORT | 2008-04-11 |
| ANNUAL REPORT | 2007-04-29 |
| ANNUAL REPORT | 2006-09-03 |
| ANNUAL REPORT | 2005-01-07 |
| ANNUAL REPORT | 2004-07-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
