| Entity Name: | PRN OF NW FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Aug 2006 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Mar 2011 (14 years ago) |
| Document Number: | P06000105253 |
| FEI/EIN Number | 205366247 |
| Address: | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL, 32561, US |
| Mail Address: | P.O. BOX 244, GONZALEZ, FL, 32560, US |
| ZIP code: | 32561 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194885350 | 2006-12-11 | 2014-06-25 | P.O. BOX 244, GONZELEZ, FL, 32560, US | 2 SUGAR BOWL LANE, PENSACOLA, FL, 32561, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 850-723-6271 |
| Fax | 8509160788 |
Authorized person
| Name | JAMES C CHANEY JR. |
| Role | OWNER |
| Phone | 8509160788 |
Taxonomy
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| License Number | ARNP 2210632 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 363LA2200X - Adult Health Nurse Practitioner |
| License Number | ARNP2210632 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 302818600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHANEY JAMES C | Agent | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL, 32561 |
| Name | Role | Address |
|---|---|---|
| CHANEY JAMES C | President | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL, 32561 |
| Name | Role | Address |
|---|---|---|
| CHANEY JAMES C | Treasurer | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL, 32561 |
| Name | Role | Address |
|---|---|---|
| CHANEY JAMES C | Secretary | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL, 32561 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-01 | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL 32561 | No data |
| PENDING REINSTATEMENT | 2011-03-01 | No data | No data |
| REINSTATEMENT | 2011-03-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-01 | CHANEY, JAMES C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-03-01 | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL 32561 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2007-04-30 | 2 SUGAR BOWL LANE, PENSACOLA BEACH, FL 32561 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-23 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-03-09 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-02-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
