| Entity Name: | FLORIDIAN FACILITY OPERATIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Nov 2014 (10 years ago) |
| Document Number: | L14000175425 |
| FEI/EIN Number | 47-2428106 |
| Address: | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL 32751 |
| Mail Address: | 1040 CROWN POINTE PKWY STE 600, ATLANTA, GA 30338-4741 |
| ZIP code: | 32751 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053718403 | 2014-12-01 | 2023-11-27 | 47 NW 32ND PL, MIAMI, FL, 331254914, US | 47 NW 32ND PL, MIAMI, FL, 331254914, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-649-2911 |
| Fax | 3055412193 |
Authorized person
| Name | KENNETH USSERY |
| Role | VP |
| Phone | 4075711550 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 11570951 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014622200 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| CONSULATE NHCG LEASEHOLDINGS, LLC | MEMBER | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL 32751 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000027276 | THE FLORIDEAN NURSING AND REHABILITATION CENTER | ACTIVE | 2015-03-16 | 2025-12-31 | No data | 47 NW 32ND PLACE, MIAMI, FL, 33125 |
| G14000119726 | FLORIDIAN HEALTHCARE | EXPIRED | 2014-12-01 | 2019-12-31 | No data | 47 NW 32ND PLACE, MIAMI, FL, 3312-5 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-24 | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL 32751 | No data |
| CHANGE OF MAILING ADDRESS | 2018-06-19 | 850 CONCOURSE PKWY S STE 250, MAITLAND, FL 32751 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J16000194450 | TERMINATED | 1000000707838 | DADE | 2016-03-10 | 2026-03-17 | $ 1,732.71 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-21 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-04-20 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
