| Entity Name: | EXCELSIS HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Sep 2020 (4 years ago) |
| Document Number: | L20000292226 |
| FEI/EIN Number | 85-3238498 |
| Mail Address: | 6625 Argyle Forest Blvd, Jacksonville, FL, 32244, US |
| Address: | 2952 Firethorn Avenue, Orange Park, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982424669 | 2024-10-16 | 2024-10-16 | 6625 ARGYLE FOREST BLVD STE 4, JACKSONVILLE, FL, 322446126, US | 2952 FIRETHORN AVE, ORANGE PARK, FL, 320731729, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 904-441-0775 |
| Phone | +1 352-494-6055 |
Authorized person
| Name | DAWN HARRIS |
| Role | FAMILY NURSE PRACTITIONER/OWNER |
| Phone | 3524946055 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| HARRIS DAWN L | Manager | 6625 ARGYLE FOREST BLVD, JACKSONVILLE, FL, 32244 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000156899 | EXCELSIS HEALTH INSTITUTE | ACTIVE | 2024-12-27 | 2029-12-31 | No data | 6625 ARGYLE FOREST BLVD STE 4, PMB 3060, JACKSONVILLE, FL, 32244 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-03-23 | 2952 Firethorn Avenue, Orange Park, FL 32073 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-03-23 | Registered Agents Inc | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-23 | 7901 4th St N, 300, St. Petersburg, FL 33702 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-04 | 2952 Firethorn Avenue, Orange Park, FL 32073 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-23 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-02-25 |
| Florida Limited Liability | 2020-09-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
