| Entity Name: | JANE M. NICHILO, ARNP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Nov 2017 (7 years ago) |
| Document Number: | L17000244862 |
| FEI/EIN Number | 82-3535569 |
| Mail Address: | 11795 Camphor Way, Seminole, FL, 33772, US |
| Address: | 5400 Seminole Blvd., Seminole, FL, 33772, US |
| ZIP code: | 33772 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932687852 | 2018-08-02 | 2018-08-02 | 11795 CAMPHOR WAY, SEMINOLE, FL, 337725700, US | 5400 SEMINOLE BLVD, SEMINOLE, FL, 337727317, US | |||||||||||||||||||||||
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| Phone | +1 830-446-9525 |
| Phone | +1 727-501-3208 |
Authorized person
| Name | MRS. JANE M NICHILO |
| Role | PMHNP-BC |
| Phone | 8304469525 |
Taxonomy
| Taxonomy Code | 163WP0808X - Psychiatric/Mental Health Registered Nurse |
| License Number | 9456593 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| NICHILO JANE M | Agent | 11795 Camphor Way, Seminole, FL, 33772 |
| Name | Role | Address |
|---|---|---|
| NICHILO JANE M | Authorized Member | 11795 Camphor Way, Seminole, FL, 33772 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-21 | 5400 Seminole Blvd., Seminole, FL 33772 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-21 | 5400 Seminole Blvd., Seminole, FL 33772 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-21 | 11795 Camphor Way, Seminole, FL 33772 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-28 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-04-06 |
| ANNUAL REPORT | 2020-05-29 |
| ANNUAL REPORT | 2019-02-21 |
| Florida Limited Liability | 2017-11-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
