| Entity Name: | SEA BREEZE PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 May 2024 (10 months ago) |
| Document Number: | L24000205180 |
| Address: | 1512 EAST JOHN SIMS PKWY, #306, NICEVILLE, FL 32578 |
| Mail Address: | 1512 EAST JOHN SIMS PKWY, #306, NICEVILLE, FL 32578 |
| ZIP code: | 32578 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548019789 | 2024-05-17 | 2024-09-05 | 26 ORIGINS MAIN ST STE 219, INLET BEACH, FL, 324618647, US | 26 ORIGINS MAIN ST STE 219, INLET BEACH, FL, 324618647, US | |||||||||||||
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| Phone | +1 850-407-2095 |
Authorized person
| Name | DR. LAWRENCE JOHN DE LAY |
| Role | OWER/PSYCHIATRIST |
| Phone | 8509129875 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| ZENBUSINESS INC. | Agent |
| Name | Role | Address |
|---|---|---|
| DE LAY, LAWRENCE J, M.D. | Authorized Member | 1512 EAST JOHN SIMS PKWY, #306, NICEVILLE, FL 32578 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-05-02 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
