| Entity Name: | SHARLYNN CARES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Oct 2020 (4 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Feb 2022 (3 years ago) |
| Document Number: | L20000319079 |
| FEI/EIN Number | 92-1577929 |
| Address: | 6900 Tavistock Lakes Blvd, ORLANDO, FL, 32827, US |
| Mail Address: | 6900 Tavistock Lakes Blvd, ORLANDO, FL, 32827, US |
| ZIP code: | 32827 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568172740 | 2022-11-29 | 2024-04-02 | 6900 TAVISTOCK LAKES BLVD STE 400, ORLANDO, FL, 328277593, US | 6900 TAVISTOCK LAKES BLVD STE 400, ORLANDO, FL, 328277593, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 305-842-4947 |
| Fax | 4072718526 |
Authorized person
| Name | LIDIA VANESSA GLADNEY |
| Role | CEO |
| Phone | 3059275272 |
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 | 364SP0808X - Psychiatric/Mental Health Clinical Nurse Specialist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 118407000 |
| State | FL |
| Issuer | FLORIDA BLUE ID |
| Number | 866H3 |
| Issuer | FLORIDA BLUE ID |
| Number | 19ZXG |
| Name | Role | Address |
|---|---|---|
| Gladney Lidia | Agent | 3564 AVALON PARK E BLVD, ORLANDO, FL, 32828 |
| Name | Role | Address |
|---|---|---|
| GLADNEY LIDIA | Authorized Representative | 6900 TAVISTOCK LAKES BLVD SUITE 400, ORLANDO, FL, 32827 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000105719 | SHARLYNN CARES PSYCHIATRY | ACTIVE | 2023-09-06 | 2028-12-31 | No data | 6900 TAVISTOCK LAKE BLVD STE 400, ORLANDO, FL, 32827 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-28 | 6900 Tavistock Lakes Blvd, SUITE 400, ORLANDO, FL 32827 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-28 | 6900 Tavistock Lakes Blvd, SUITE 400, ORLANDO, FL 32827 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-12 | Gladney, Lidia | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-12 | 3564 AVALON PARK E BLVD, SUITE 1, ORLANDO, FL 32828 | No data |
| REINSTATEMENT | 2022-02-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-12 |
| AMENDED ANNUAL REPORT | 2022-06-10 |
| REINSTATEMENT | 2022-02-10 |
| Florida Limited Liability | 2020-10-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
