Search icon

SOVEREIGN HEALTHCARE OF MEDICANA, LLC - Florida Company Profile

Company claim

Is this your business?

Get access!

Company Details

Entity Name: SOVEREIGN HEALTHCARE OF MEDICANA, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active
Date Filed: 15 Jul 2003 (22 years ago)
Document Number: M03000002334
FEI/EIN Number 200185150
Mail Address: 101 Sunnytown Road, Casselberry, FL, 32707, US
Address: 1710 Lake Worth Road, Lake Worth, FL, 33460, US
ZIP code: 33460
City: Lake Worth Beach
County: Palm Beach
Place of Formation: DELAWARE

Key Officers & Management

Role
Manager
Agent

Unique Entity ID

CAGE Code:
6RPT1
UEI Expiration Date:
2018-02-04

Business Information

Doing Business As:
MEDICANA NURSING & REHAB CENTER
Activation Date:
2017-02-04
Initial Registration Date:
2012-05-18

Commercial and government entity program

CAGE number:
6RPT1
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2022-03-24
CAGE Expiration:
2022-03-23

Contact Information

POC:
DONALD K MELTON

National Provider Identifier

NPI Number:
1609863307

Authorized Person:

Name:
MR. R. MARK CRONQUIST
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
314000000X - Skilled Nursing Facility
Is Primary:
Yes

Contacts:

Fax:
4045742105
Fax:
5615825354

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G09048900146 MEDICANA NURSING AND REHAB CENTER ACTIVE 2009-02-17 2029-12-31 - 1710 LAKE WORTH ROAD, SUITE 201, LAKE WORTH, FL, 33460

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2017-03-30 1710 Lake Worth Road, Lake Worth, FL 33460 -
REGISTERED AGENT ADDRESS CHANGED 2015-07-07 115 North Calhoun St., Suite 4, Tallahassee, FL 32301 -
CHANGE OF MAILING ADDRESS 2014-01-14 1710 Lake Worth Road, Lake Worth, FL 33460 -

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-03-08
ANNUAL REPORT 2022-02-18
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-04-13
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-03-25
ANNUAL REPORT 2015-01-09

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 02 Aug 2025

Sources: Florida Department of State