| Entity Name: | CERTI-FI NP, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Apr 2018 (7 years ago) |
| Document Number: | L18000099122 |
| FEI/EIN Number | 82-5315934 |
| Mail Address: | 11582 SW Village Pkwy, PORT ST LUCIE, FL, 34987, US |
| Address: | 3174 NW FEDERAL HWY #3490, JENSEN BEACH, FL, 34957, US |
| ZIP code: | 34957 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013639525 | 2022-09-13 | 2024-08-06 | 3174 NW FEDERAL HWY # 3490, SUITE 302-303, JENSEN BEACH, FL, 34957, US | 3174 NW FEDERAL HWY # 3490, SUITE 302-303, JENSEN BEACH, FL, 34957, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-298-2823 |
| Fax | 8008601168 |
Authorized person
| Name | LATOYA CHERRY |
| Role | MSN, FNP-BC, AGACNP-BC / TIN OWNER |
| Phone | 7866795825 |
Taxonomy
| Taxonomy Code | 163WW0000X - Wound Care Registered Nurse |
| Is Primary | No |
| Taxonomy Code | 363LA2100X - Acute Care Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LG0600X - Gerontology Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE NUMBER |
| Number | 9247990 |
| State | FL |
| Issuer | MEDICAID |
| Number | 116451500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Cherry LaToya | Agent | 4200 NW 16th St, Lauderhill, FL, 33313 |
| Name | Role | Address |
|---|---|---|
| CHERRY LATOYA | Member | 11582 SW VILLAGE PKWY, PORT ST LUCIE, FL, 34987 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000008966 | CERTI-FI WOUND CARE | ACTIVE | 2025-01-21 | 2030-12-31 | No data | 3174 NW FEDERAL HWY #3490, SUITE 302-303, JENSEN BEACH, FL, 34957 |
| G24000144747 | TREASURE COAST NP | ACTIVE | 2024-11-27 | 2029-12-31 | No data | 3174 NW FEDERAL HWY 3490 SUITE 302-303, JENSEN BEACH, FL, 34957 |
| G18000091387 | FOREVERBODY | EXPIRED | 2018-08-16 | 2023-12-31 | No data | 550 SW 63RD AVE, MARGATE, FL, 33068 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-10-22 | 3174 NW FEDERAL HWY #3490, STE 302-303, JENSEN BEACH, FL 34957 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-09 | 3174 NW FEDERAL HWY #3490, STE 302-303, JENSEN BEACH, FL 34957 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-22 | 4200 NW 16th St, Suite 427, Lauderhill, FL 33313 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-09-15 | Cherry, LaToya | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-09-15 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-05-09 |
| ANNUAL REPORT | 2020-06-30 |
| ANNUAL REPORT | 2019-04-30 |
| Florida Limited Liability | 2018-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
