| Entity Name: | OCEANSIDE HEALTH AND WELLNESS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Feb 2022 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Oct 2024 (4 months ago) |
| Document Number: | L22000097566 |
| FEI/EIN Number | 882969379 |
| Address: | 1910 82nd Ave, Suite 105, Vero Beach, FL, 32966, US |
| Mail Address: | 1910 82nd Ave, Suite 105, Vero Beach, FL, 32966, US |
| ZIP code: | 32966 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982336327 | 2022-06-24 | 2022-06-24 | 8116 AMALFI CIR, FORT PIERCE, FL, 349514400, US | 8116 AMALFI CIR, FORT PIERCE, FL, 349514400, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 304-415-5783 |
Authorized person
| Name | JESSE LEE MACE |
| Role | OWNER/PROVIDER |
| Phone | 3044155783 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MACE JESSE L | Agent | 8116 AMALFI CIRCLE, FORT PIERCE, FL, 34951 |
| Name | Role | Address |
|---|---|---|
| Mace Jesse L | APRN | 1910 82nd Ave, Vero Beach, FL, 32966 |
| Name | Role | Address |
|---|---|---|
| Huffman-Mace Kirstin N | Admi | 1910 82nd Ave, Vero Beach, FL, 32966 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-10-17 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-10-17 | 1910 82nd Ave, Suite 105, Vero Beach, FL 32966 | No data |
| CHANGE OF MAILING ADDRESS | 2024-10-17 | 1910 82nd Ave, Suite 105, Vero Beach, FL 32966 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-17 | MACE, JESSE L | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-10-17 |
| ANNUAL REPORT | 2023-04-29 |
| Florida Limited Liability | 2022-02-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
