| Entity Name: | EASTWINDS OF FLORIDA INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Jun 2004 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2021 (3 years ago) |
| Document Number: | P04000086451 |
| FEI/EIN Number | 830400812 |
| Address: | 112 12TH AVE N, SAINT PETERSBURG, FL, 33701, US |
| Mail Address: | 112 12 AVE N, ST PETERSBURG, FL, 33701 |
| ZIP code: | 33701 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386823599 | 2007-10-24 | 2016-08-19 | 1725 ROBINHOOD LN, CLEARWATER, FL, 337646449, US | 112 12TH AVE N, ST PETERSBURG, FL, 337011826, US | |||||||||||||||||||||||
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| Phone | +1 727-821-8510 |
Authorized person
| Name | MR. FLOYD M. MCKENZIE |
| Role | ADMINISTRATOR |
| Phone | 7278218510 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | AL5405 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 687826196 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LUBINGA DENIS | Agent | 112 12TH AVE N, SAINT PETERSBURG, FL, 33701 |
| Name | Role | Address |
|---|---|---|
| LUBINGA DENIS | President | 114 Valencia Circle,, st petersburg, FL, 33716 |
| Name | Role | Address |
|---|---|---|
| LUBINGA DENIS | Director | 114 Valencia Circle,, st petersburg, FL, 33716 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000141737 | AZALEA MANOR | ACTIVE | 2021-10-21 | 2026-12-31 | No data | 112 12TH AVENUE NORTH, ST.PETERSBURG, FL, 33701 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-09-30 | LUBINGA, DENIS | No data |
| REINSTATEMENT | 2021-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| AMENDMENT | 2018-04-09 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-09 | 112 12TH AVE N, SAINT PETERSBURG, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-09 | 112 12TH AVE N, SAINT PETERSBURG, FL 33701 | No data |
| AMENDMENT | 2017-12-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-05-02 | 112 12TH AVE N, SAINT PETERSBURG, FL 33701 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-04-26 |
| REINSTATEMENT | 2021-09-30 |
| ANNUAL REPORT | 2020-06-12 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-05-01 |
| Amendment | 2018-04-09 |
| Amendment | 2017-12-11 |
| ANNUAL REPORT | 2017-02-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
