| Entity Name: | EPIFANI LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Jan 2016 (9 years ago) |
| Document Number: | L16000007348 |
| FEI/EIN Number | 81-1042074 |
| Address: | 2 Islandview Dr, Mary Esther, FL 32569 |
| Mail Address: | 2 Islandview Dr, Mary Esther, FL 32569 |
| ZIP code: | 32569 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760036859 | 2019-07-28 | 2019-07-28 | 1704 CARTIER PL, FORT WALTON BEACH, FL, 325475730, US | 1704 CARTIER PL, FORT WALTON BEACH, FL, 325475730, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 850-687-7890 |
Authorized person
| Name | URSULA NKWANTABISA |
| Role | OWNER |
| Phone | 8506877890 |
Taxonomy
| Taxonomy Code | 376J00000X - Homemaker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103096400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NKWANTABISA, URSULA N | Agent | 2 Islandview Dr, Mary Esther, FL 32569 |
| Name | Role | Address |
|---|---|---|
| NKWANTABISA, URSULA N | Manager | 2 Islandview Dr, Mary Esther, FL 32569 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000131708 | 1 HEART CARE SOLUTIONS | EXPIRED | 2018-12-12 | 2023-12-31 | No data | 1704 CARTIER PLACE, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-07-08 | 2 Islandview Dr, Mary Esther, FL 32569 | No data |
| CHANGE OF MAILING ADDRESS | 2020-07-08 | 2 Islandview Dr, Mary Esther, FL 32569 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-07-08 | 2 Islandview Dr, Mary Esther, FL 32569 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-07-08 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-29 |
| Florida Limited Liability | 2016-01-11 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
