Search icon

ANITA L. PETTEWAY, M.D., P.A. - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: ANITA L. PETTEWAY, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 15 Oct 1998 (27 years ago)
Document Number: P98000088349
FEI/EIN Number 650879460
Address: 150 NW 168TH STREET, NORTH MIAMI BCH, FL, 33169, US
Mail Address: 150 NW 168TH STREET, north miami beach, FL, 33169, US
ZIP code: 33169
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PETTEWAY ANITA L President 19410 SW 17th Court, MIRAMAR, FL, 33029
MILHOMME-SIMMONS TANYA Agent 111 N. Pine Island Road Suite 208, Plantation, FL, 33324

National Provider Identifier

NPI Number:
1558322289
Certification Date:
2024-08-22

Authorized Person:

Name:
MRS. DORENDA WASHINGTON
Role:
DIRECTOR OF OPERATIONS
Phone:

Taxonomy:

Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8774889590

Form 5500 Series

Employer Identification Number (EIN):
650879460
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000100327 PREMIER MULTISPECIALTY MEDICAL CENTER ACTIVE 2021-08-02 2026-12-31 - 150 NW 168TH STREET, SUITE 200, NORTH MIAMI BEACH, FL, 33169

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-26 150 NW 168TH STREET, SUITE 301, NORTH MIAMI BCH, FL 33169 -
CHANGE OF MAILING ADDRESS 2023-11-01 150 NW 168TH STREET, SUITE 301, NORTH MIAMI BCH, FL 33169 -
REGISTERED AGENT NAME CHANGED 2020-02-26 MILHOMME-SIMMONS, TANYA -
REGISTERED AGENT ADDRESS CHANGED 2020-02-26 111 N. Pine Island Road Suite 208, Plantation, FL 33324 -

Documents

Name Date
ANNUAL REPORT 2024-04-26
ANNUAL REPORT 2023-04-26
ANNUAL REPORT 2022-02-04
ANNUAL REPORT 2021-03-09
ANNUAL REPORT 2020-02-26
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-04-04
ANNUAL REPORT 2017-03-27
ANNUAL REPORT 2016-04-25
ANNUAL REPORT 2015-04-08

Paycheck Protection Program

Jobs Reported:
7
Initial Approval Amount:
$73,500
Date Approved:
2020-04-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$73,500
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$74,451.42
Servicing Lender:
Citibank, N.A.
Use of Proceeds:
Payroll: $73,500
Jobs Reported:
7
Initial Approval Amount:
$58,100
Date Approved:
2021-03-23
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$58,100
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$58,876.28
Servicing Lender:
Citibank, N.A.
Use of Proceeds:
Payroll: $58,098
Utilities: $1

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 03 Jul 2025

Sources: Florida Department of State