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WINTER HAVEN NURSING, LLC - Florida Company Profile

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Company Details

Entity Name: WINTER HAVEN NURSING, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 May 2021 (4 years ago)
Document Number: L21000210006
FEI/EIN Number 87-1102653
Address: 3599 W. LAKE MARY BLVD, LAKE MARY, FL, 32746, US
Mail 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
EDMANDS ANTHONY Manager 3599 W. LAKE MARY BLVD., SUITE 1F, LAKE MARY, FL, 32746
SWAIN STEWART JR. Manager 3599 W. LAKE MARY BLVD., SUITE 1F, LAKE MARY, FL, 32746
- Agent -

U.S. Small Business Administration Profile

Phone Number:
E-mail Address:
Contact Person:
JARED WRIGHT
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business
User ID:
P2702364

Unique Entity ID

Unique Entity ID:
WK2SLNTQ7SM4
CAGE Code:
9A0U0
UEI Expiration Date:
2026-04-29

Business Information

Division Name:
THE PALMS NURSING AND REHAB AT WINTER HAVEN
Activation Date:
2025-05-01
Initial Registration Date:
2022-03-15

National Provider Identifier

NPI Number:
1154998995
Certification Date:
2021-06-09

Authorized Person:

Name:
VICTORIA SHARPLESS
Role:
DIRECTOR OF ACCOUNTING
Phone:

Taxonomy:

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

Contacts:

Fax:
3524044078
Fax:
8632996427

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000076632 THE PALMS NURSING AND REHAB AT WINTER HAVEN ACTIVE 2021-06-08 2026-12-31 - 1801 NORTH LAKE MARIAM DR., WINTER HAVEN, FL, 33884

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-04-25 PARACORP INCORPORATED -
REGISTERED AGENT ADDRESS CHANGED 2024-04-25 155 OFFICE PLAZA DR., 1ST, TALLAHASSEE, FL 32301 -
CHANGE OF PRINCIPAL ADDRESS 2021-08-13 3599 W. LAKE MARY BLVD, Suite 1-F, LAKE MARY, FL 32746 -
CHANGE OF MAILING ADDRESS 2021-08-13 3599 W. LAKE MARY BLVD, Suite 1-F, LAKE MARY, FL 32746 -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-04-25
ANNUAL REPORT 2024-03-19
Reg. Agent Resignation 2023-09-13
ANNUAL REPORT 2023-04-13
ANNUAL REPORT 2022-04-13
Florida Limited Liability 2021-05-05

USAspending Awards / Contracts

Procurement Instrument Identifier:
36C24825N0385
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
600000.00
Base And Exercised Options Value:
600000.00
Base And All Options Value:
600000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2025-03-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: NURSING HOME, LONG-TERM & ADULT DAY CARE SERVICES
Procurement Instrument Identifier:
36C24824N0422
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
600000.00
Base And Exercised Options Value:
600000.00
Base And All Options Value:
600000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2024-03-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS
Procurement Instrument Identifier:
36C24823N0363
Award Or Idv Flag:
AWARD
Award Type:
DELIVERY ORDER
Action Obligation:
600000.00
Base And Exercised Options Value:
600000.00
Base And All Options Value:
600000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2023-03-01
Description:
NURSING HOME SERVICES
Naics Code:
623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product Or Service Code:
Q402: MEDICAL- NURSING HOME CARE CONTRACTS

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Date of last update: 02 Aug 2025

Sources: Florida Department of State