| Entity Name: | PORT ST. LUCIE NURSING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PORT ST. LUCIE NURSING, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 05 May 2021 (4 years ago) |
| Document Number: | L21000210079 |
| FEI/EIN Number |
871128373
Federal Employer Identification (FEI) Number assigned by the IRS. |
| 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 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043887631 | 2021-06-10 | 2021-06-10 | 3599 W LAKE MARY BLVD, LAKE MARY, FL, 327463417, US | 1655 SE WALTON RD, PORT ST LUCIE, FL, 349527657, US | |||||||||||||||||||||||||
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| Phone | +1 352-874-6007 |
| Fax | 3524044078 |
| Phone | +1 772-337-1333 |
| Fax | 7723376485 |
Authorized person
| Name | VICTORIA SHARPLESS |
| Role | DIRECTOR OF ACCOUNTING |
| Phone | 3528746007 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 261637-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EDMANDS ANTHONY | Manager | 3599 W. LAKE MARY BLVD., SUITE 1F, LAKE MARY, FL, 32746 |
| SWAIN STEWART JR. | Manager | 980 KAYE GIBBONS CT, KERNERSVILLE, NC, 27284 |
| PARACORP INCORPORATED | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000076639 | THE PALMS NURSING AND REHAB AT PORT ST. LUCIE | ACTIVE | 2021-06-08 | 2026-12-31 | - | 1655 SW WALTON RD, PORT ST. LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| 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 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000463414 | ACTIVE | 562023CC001867AXXXHC | CIRCUIT COURT ST. LUCIE COUNTY | 2023-08-22 | 2028-10-03 | $38,527.52 | MEDICAL IMAGING, INC., 5000 NW 27TH COURT, SUITE B., GAINESVILLE, FL 32606 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-19 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-04-13 |
| Florida Limited Liability | 2021-05-05 |
Date of last update: 03 Mar 2025
Sources: Florida Department of State
