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LAKE CITY NURSING, LLC - Florida Company Profile

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Company Details

Entity Name: LAKE CITY NURSING, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 May 2021 (4 years ago)
Document Number: L21000209963
FEI/EIN Number 871088123
Mail Address: 3599 W LAKE MARY BLVD, LAKE MARY, FL, 32746, US
Address: 3599 W. LAKE MARY BLVD., LAKE MARY, FL, 32746, US
ZIP code: 32746
City: Lake Mary
County: Seminole
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
SWAIN STEWART JR. Manager 980 KAY GIBBONS CT., KERNERSVILE, NC, 27284
EDMANDS ANTHONY Manager 3599 W. LAKE MARY BLVD, STE 1-F, LAKE MARY, FL, 32746
- Agent -

National Provider Identifier

NPI Number:
1194392936
Certification Date:
2021-06-09
Link:
View on NPI website

Authorized Person:

Name:
VICTORIA SHARPLESS
Role:
DIRECTOR OF ACCOUNTING
Phone:
3528746007

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Phone:
+1 352-874-6007
Fax:
3524044078
Phone:
+1 386-752-7900
Fax:
3867586169

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000076635 THE PALMS NURSING AND REHAB AT LAKE CITY ACTIVE 2021-06-08 2026-12-31 - 1270 SW MAIN BLVD., LAKE CITY, FL, 32025

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-08-13 3599 W. LAKE MARY BLVD., SUITE 1F, LAKE MARY, FL 32746 -
CHANGE OF MAILING ADDRESS 2021-08-13 3599 W. LAKE MARY BLVD., SUITE 1F, LAKE MARY, FL 32746 -

Documents

Name Date
ANNUAL REPORT 2024-03-19
ANNUAL REPORT 2023-04-13
ANNUAL REPORT 2022-04-13
Florida Limited Liability 2021-05-05

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Date of last update: 02 Aug 2025

Sources: Florida Department of State

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