| Entity Name: | BLUE LAKE POST ACUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Jun 2022 (3 years ago) |
| Document Number: | L22000282540 |
| FEI/EIN Number | 88-3004824 |
| Address: | 769 NE 77th Terrace, Miami, FL, 33138, US |
| Mail Address: | 769 NE 77th Terrace, Miami, FL, 33138, US |
| ZIP code: | 33138 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710613500 | 2022-07-25 | 2023-01-19 | 991 E NEW YORK AVE, DELAND, FL, 327245664, US | 991 E NEW YORK AVE, DELAND, FL, 327245664, US | |||||||||||||
|
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| Phone | +1 386-734-9083 |
Authorized person
| Name | SCOTT H TANNER |
| Role | LEGAL COUNSEL |
| Phone | 9494305178 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
| Name | Role |
|---|---|
| PARACORP INCORPORATED | Agent |
| Name | Role | Address |
|---|---|---|
| FUNK KENNETH | Manager | 769 NE 77th Terrace, Miami, FL, 33138 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000086537 | BLUE LAKE POST ACUTE | ACTIVE | 2022-07-21 | 2027-12-31 | No data | 991 E NEW YORK AVENUE, DELAND, FL, 32724 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-19 | 769 NE 77th Terrace, Miami, FL 33138 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-19 | 769 NE 77th Terrace, Miami, FL 33138 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-05-11 | PARACORP INCORPORATED | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-11 | 155 Office Plaza Drive, 1st Floor, Tallahassee, FL 32301 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000500700 | TERMINATED | 1000001005646 | VOLUSIA | 2024-08-01 | 2034-08-07 | $ 814.92 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 3750 NW 87TH AVE STE 300, DORAL FL331782430 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-19 |
| AMENDED ANNUAL REPORT | 2023-05-11 |
| ANNUAL REPORT | 2023-02-13 |
| Florida Limited Liability | 2022-06-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
