| Entity Name: | NOURISH FOOT CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 29 Dec 2014 (10 years ago) |
| Date of dissolution: | 25 Jul 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 25 Jul 2018 (7 years ago) |
| Document Number: | L14000195507 |
| FEI/EIN Number | 47-2634952 |
| Address: | 9700 PHILIPS HWY., 107, JACKSONVILLE, FL, 32256 |
| Mail Address: | 9700 PHILIPS HWY., 107, JACKSONVILLE, FL, 32256 |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114315165 | 2014-12-29 | 2017-04-05 | 8640 PHILIPS HWY, STE 10, JACKSONVILLE, FL, 322561207, US | 8640 PHILIPS HWY, STE 10, JACKSONVILLE, FL, 322561207, US | |||||||||||||||||||||||||
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| Phone | +1 904-469-2432 |
| Fax | 9047793348 |
Authorized person
| Name | WILLIAM DANZEISEN |
| Role | DPM |
| Phone | 9044692432 |
Taxonomy
| Taxonomy Code | 213E00000X - Podiatrist |
| License Number | PO1571 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 017367800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BRAHMBHATT SACHIN A | Agent | 11973 LAZARETTE CT., JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| DANZEISEN WILLIAM C | Manager | 1105 PINE MILL LANE, PONTE VEDRA, FL, 32082 |
| BRAHMBHATT SACHIN A | Manager | 11973 LAZARETTE CT., JACKSONVILLE, FL, 32258 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-07-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-25 | 11973 LAZARETTE CT., JACKSONVILLE, FL 32258 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-25 |
| Florida Limited Liability | 2014-12-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
