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PORT ST. LUCIE NURSING, LLC - Florida Company Profile

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Company Details

Entity Name: PORT ST. LUCIE NURSING, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 May 2021 (4 years ago)
Document Number: L21000210079
FEI/EIN Number 871128373
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 980 KAYE GIBBONS CT, KERNERSVILLE, NC, 27284
- Agent -

National Provider Identifier

NPI Number:
1043887631
Certification Date:
2021-06-10

Authorized Person:

Name:
VICTORIA SHARPLESS
Role:
DIRECTOR OF ACCOUNTING
Phone:

Taxonomy:

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

Contacts:

Fax:
3524044078
Fax:
7723376485

Fictitious Names

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

Events

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 -

Debts

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

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: 03 Aug 2025

Sources: Florida Department of State