| Entity Name: | FLORIDA STATE NURSE REGISTRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Jul 2020 (5 years ago) |
| Document Number: | L20000186738 |
| FEI/EIN Number | 851776916 |
| Address: | 290 CITRUS TOWER BLVD, CLERMONT, FL, 34711, US |
| Mail Address: | 290 CITRUS TOWER BLVD, CLERMONT, FL, 34711, US |
| ZIP code: | 34711 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255932851 | 2020-11-02 | 2020-11-02 | 7003 PRESIDENTS DR STE 800, ORLANDO, FL, 328095530, US | 290 CITRUS TOWER BLVD STE 229, CLERMONT, FL, 347112786, US | |||||||||||||||||
|
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| Phone | +1 522-616-4753 |
Authorized person
| Name | JEFFREY RIVERA |
| Role | ADMINISTRATOR |
| Phone | 1407440287 |
Taxonomy
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NONE |
| Number | NONE |
| Name | Role | Address |
|---|---|---|
| ROWE JEROME P | Agent | 1600 REGAL COVE COURT, KISSIMMEE, FL, 34744 |
| Name | Role | Address |
|---|---|---|
| ROWE JEROME P | Manager | 1600 REGAL COVE COURT, KISSIMMEE, FL, 34744 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-06 | 290 CITRUS TOWER BLVD, SUITE 229, CLERMONT, FL 34711 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-06 | 290 CITRUS TOWER BLVD, SUITE 229, CLERMONT, FL 34711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-26 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-02-21 |
| Florida Limited Liability | 2020-07-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
