| Entity Name: | FELYCIA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 May 2021 (4 years ago) |
| Document Number: | L21000232577 |
| FEI/EIN Number | 86-3984450 |
| Address: | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| Mail Address: | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| ZIP code: | 33598 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780435560 | 2024-03-29 | 2024-03-29 | 15410 WINTER BREEZE LN, WIMAUMA, FL, 335982219, US | 15410 WINTER BREEZE LN, WIMAUMA, FL, 335982219, US | |||||||||||||||||||
|
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| Phone | +1 813-850-6663 |
Authorized person
| Name | MRS. WIDLYNE FLORISSANT |
| Role | ADMINISTRATOR/OWNER |
| Phone | 8138506663 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 114223900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FLORISSANT WIDLYNE B | Agent | 15410 WINTER BREEZE LN, WMAUMA, FL, 33598 |
| Name | Role | Address |
|---|---|---|
| FLORISSANT WIDLYNE B | President | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| Name | Role | Address |
|---|---|---|
| FLORISSANT FLETCHER J | Manager | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| Name | Role | Address |
|---|---|---|
| PATRY MICHAELA S | Auth | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| FLORISSANT WHITLEY A | Auth | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| Florissant Brianna J | Auth | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000032788 | FELYCIA'S HOME | ACTIVE | 2022-03-12 | 2027-12-31 | No data | 15410 WINTER BREEZE LN, WIMAUMA, FL, 33598 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-02-15 |
| Florida Limited Liability | 2021-05-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
