| Entity Name: | SIGNATURE STAFF SOLUTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 05 Nov 2012 (12 years ago) |
| Date of dissolution: | 23 Mar 2019 (6 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 23 Mar 2019 (6 years ago) |
| Document Number: | L12000140162 |
| FEI/EIN Number | 46-1335859 |
| Address: | 10950-60 SAN JOSE BLVD,, JACKSONVILLE, FL, 32223, US |
| Mail Address: | 10950-60 SAN JOSE BLVD,, JACKSONVILLE, FL, 32223, US |
| ZIP code: | 32223 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1316369044 | 2014-01-15 | 2014-01-15 | 138 PALM COAST PKWY NE # 258, PALM COAST, FL, 321378241, US | 3830 CROWN POINT RD STE F, JACKSONVILLE, FL, 322577553, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-679-1819 |
| Fax | 9046478096 |
Authorized person
| Name | MATANA MANOMAT |
| Role | ADMINISTRATOR |
| Phone | 9046791819 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| License Number | 1585 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 163WI0500X - Infusion Therapy Registered Nurse |
| License Number | 1585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 164W00000X - Licensed Practical Nurse |
| License Number | 1585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| License Number | 1585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3747P1801X - Personal Care Attendant |
| License Number | 1585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 374U00000X - Home Health Aide |
| License Number | 1585 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 376K00000X - Nurse's Aide |
| License Number | 1585 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | AHCA HEALTH CARE SERVICES POOL |
| Number | 1585 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Manomat Matana | Agent | 10950-60 SAN JOSE BLVD,, JACKSONVILLE, FL, 32223 |
| Name | Role | Address |
|---|---|---|
| MANOMAT MATANA | Managing Member | 10950-60 SAN JOSE BLVD, JACKSONVILLE, FL, 32223 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000069707 | PARTNERS IN CARE | EXPIRED | 2014-07-05 | 2019-12-31 | No data | 830 AIA N 13, #472, PONTE VEDRA BCH, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-03-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-18 | 10950-60 SAN JOSE BLVD,, SUITE #258, JACKSONVILLE, FL 32223 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-09-20 | 10950-60 SAN JOSE BLVD,, SUITE #258, JACKSONVILLE, FL 32223 | No data |
| CHANGE OF MAILING ADDRESS | 2017-09-20 | 10950-60 SAN JOSE BLVD,, SUITE #258, JACKSONVILLE, FL 32223 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-03-08 | Manomat, Matana | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-03-23 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-05-12 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-01-24 |
| ANNUAL REPORT | 2013-02-04 |
| Florida Limited Liability | 2012-11-05 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
