| Entity Name: | BLUE SEA MENTAL HEALTH PRACTITIONERS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Nov 2020 (4 years ago) |
| Document Number: | L20000362997 |
| FEI/EIN Number | 85-4079560 |
| Address: | 231 RIVERSIDE DRIVE,, #1801, HOLLY HILL, FL, 32117, US |
| Mail Address: | 231 RIVERSIDE DRIVE,, #1801, HOLLY HILL, FL, 32117, US |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821798414 | 2023-03-03 | 2023-03-03 | 231 RIVERSIDE DR UNIT 1801, HOLLY HILL, FL, 321174966, US | 231 RIVERSIDE DR UNIT 1801, HOLLY HILL, FL, 321174966, US | |||||||||||||
|
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| Phone | +1 386-232-8089 |
Authorized person
| Name | CYNTHIA MICHELLE BAXTER |
| Role | OWNER |
| Phone | 3862328089 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| BAXTER CYNTHIA M | Authorized Member | 231 RIVERSIDE DRIVE,, HOLLY HILL, FL, 32117 |
| BAXTER MATTHEW R | Authorized Member | 231 RIVERSIDE DRIVE,, HOLLY HILL, FL, 32117 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-06 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-02-08 | 231 RIVERSIDE DRIVE,, #1801, HOLLY HILL, FL 32117 | No data |
| CHANGE OF MAILING ADDRESS | 2022-02-08 | 231 RIVERSIDE DRIVE,, #1801, HOLLY HILL, FL 32117 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-15 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-04-11 |
| Florida Limited Liability | 2020-11-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
