| Entity Name: | VERDANT HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Aug 2021 (3 years ago) |
| Document Number: | L21000385488 |
| FEI/EIN Number | 87-4243437 |
| Address: | 152 HIDDEN VIEW DR, GROVELAND, FL, 34736 |
| Mail Address: | 152 HIDDEN VIEW DR, GROVELAND, FL, 34736 |
| ZIP code: | 34736 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205543253 | 2022-10-31 | 2024-07-11 | PO BOX 120512, CLERMONT, FL, 347120512, US | 152 HIDDEN VIEW DR, GROVELAND, FL, 347368836, US | |||||||||||||||||||||
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| Phone | +1 352-227-0418 |
| Fax | 4072793310 |
Authorized person
| Name | ERIKA CORTES |
| Role | OWNER |
| Phone | 3522270418 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104265400 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VERDANT HEALTH | 2023 | 874243437 | 2024-11-07 | VERDANT HEALTH LLC | 2 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-11-07 |
| Name of individual signing | ERIKA CORTES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CORTES ERIKA | Agent | 152 HIDDEN VIEW DR, GROVELAND, FL, 34736 |
| Name | Role | Address |
|---|---|---|
| CORTES ERIKA | Manager | 152 HIDDEN VIEW DR, GROVELAND, FL, 34736 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-03-31 |
| Florida Limited Liability | 2021-08-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
