| Entity Name: | NURSESPRING OF PENSACOLA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Jul 2001 (23 years ago) |
| Document Number: | L01000012317 |
| FEI/EIN Number | 522332046 |
| Mail Address: | 9120 MIDLOTHIAN TURNPIKE, RICHMOND, VA, 23235, US |
| Address: | 5500 N DAVIS HIGHWAY, PENSACOLA, FL, 32503, US |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023346764 | 2009-11-18 | 2023-09-08 | 9120 MIDLOTHIAN TNPK, RICHMOND, VA, 23235, US | 5500 N DAVIS HWY, PENSACOLA, FL, 325032064, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 804-560-9400 |
| Fax | 8042728833 |
| Phone | +1 850-479-8620 |
| Fax | 8504798668 |
Authorized person
| Name | MR. BRYAN DAVID KRAUSE |
| Role | CEO/PRESIDENT |
| Phone | 8045609400 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299992233 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 3747A0650X - Attendant Care Provider |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 6912656 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HOFFMAN MATTHEW C | Agent | 151 W. MAIN ST., STE. 200, PENSACOLA, FL, 32502 |
| Name | Role | Address |
|---|---|---|
| KRAUSE BRYAN D | Manager | 9120 MIDLOTHIAN TNPK, RICHMOND, VA, 23235 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000017617 | NURSESPRING | EXPIRED | 2016-02-18 | 2021-12-31 | No data | 9120 MIDLOTHIAN TURNPIKE, RICHMOND, VA, 23235 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2023-09-18 | No data | No data |
| REINSTATEMENT | 2020-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| LC NAME CHANGE | 2016-01-20 | NURSESPRING OF PENSACOLA, LLC | No data |
| LC NAME CHANGE | 2015-12-17 | NURSEPNS, LLC | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
