| Entity Name: | SEASIDE PRIMARY CARE AND PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Mar 2020 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 09 May 2022 (3 years ago) |
| Document Number: | L20000081330 |
| FEI/EIN Number | 851171102 |
| Address: | 9670 MEADOW WOOD LANE, NAVARRE, FL, 32566, US |
| Mail Address: | 9670 MEADOW WOOD LANE, NAVARRE, FL, 32566, US |
| ZIP code: | 32566 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730704875 | 2020-06-15 | 2022-10-10 | 9670 MEADOW WOOD LN, NAVARRE, FL, 325662876, US | 1931 ORTEGA ST, NAVARRE, FL, 325664111, US | |||||||||||||||||||||||||||
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| Phone | +1 850-684-1410 |
| Fax | 8339890937 |
Authorized person
| Name | MRS. ANGELA SANDERS |
| Role | OWNER/NURSE PRACTITIONER |
| Phone | 8506841410 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SANDERS ANGELA D | Agent | 9670 MEADOW WOOD LANE, NAVARRE, FL, 32566 |
| Name | Role | Address |
|---|---|---|
| SANDERS ANGELA | Owner | 9670 MEADOW WOOD LANE, NAVARRE, FL, 32566 |
| Name | Role | Address |
|---|---|---|
| SANDERS GILBERT | Vice President | 9670 MEADOW WOOD LANE, NAVARRE, FL, 32566 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2022-05-09 | No data | No data |
| LC AMENDMENT | 2020-08-31 | No data | No data |
| LC AMENDMENT | 2020-06-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-07 |
| ANNUAL REPORT | 2023-05-01 |
| LC Amendment | 2022-05-09 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-03-14 |
| LC Amendment | 2020-08-31 |
| LC Amendment | 2020-06-19 |
| Florida Limited Liability | 2020-03-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
