| Entity Name: | PENSACOLA OPCO, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Jan 2022 (3 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 18 Nov 2024 (3 months ago) |
| Document Number: | M22000001274 |
| Address: | 235 W. AIRPORT BLVD, PENSACOLA, FL, 32505, US |
| Mail Address: | 235 W. AIRPORT BLVD, PENSACOLA, FL, 32505, US |
| ZIP code: | 32505 |
| County: | Escambia |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922750405 | 2022-01-25 | 2022-01-25 | 235 W AIRPORT BLVD, PENSACOLA, FL, 325052239, US | 235 W AIRPORT BLVD, PENSACOLA, FL, 325052239, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 850-857-5200 |
| Fax | 8504772235 |
Authorized person
| Name | MATHEW VARGHESE |
| Role | MEMBER |
| Phone | 9178173530 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | 130470965 |
| State | FL |
| Name | Role |
|---|---|
| PLATINUM AGENT SERVICES LLC | Agent |
| Name | Role | Address |
|---|---|---|
| WOZNIAK DAWN M | Auth | 10150 Highland Manor Drive, Tampa, FL, 33610 |
| Name | Role |
|---|---|
| PENSACOLA MEMBER, LLC | Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000016640 | PENSACOLA NURSING & REHABILITATION CENTER | ACTIVE | 2022-02-09 | 2027-12-31 | No data | 235 W. AIRPORT BLVD, PENSACOLA, FL, 32505 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2024-11-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-11-18 | PLATINUM AGENT SERVICES LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-11-18 | 155 OFFICE PLAZA DR., TALLAHASSEE, FL 32301 | No data |
| REINSTATEMENT | 2023-10-17 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| CORLCRACHG | 2024-11-18 |
| AMENDED ANNUAL REPORT | 2024-10-28 |
| ANNUAL REPORT | 2024-03-07 |
| REINSTATEMENT | 2023-10-17 |
| Foreign Limited | 2022-01-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
