| Entity Name: | SEALIFE PSYCHIATRIC SERVICES, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Jan 2011 (14 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P11000007054 |
| FEI/EIN Number | 274627888 |
| Address: | 14201 W SUNRISE BLVD, SUITE 208, SUNRISE, FL, 33323, US |
| Mail Address: | 14201 W SUNRISE BLVD, SUITE 208, SUNRISE, FL, 33323, US |
| ZIP code: | 33323 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851698682 | 2011-02-14 | 2013-08-05 | 14201 W SUNRISE BLVD, STE 208, SUNRISE, FL, 333233207, US | 14201 W SUNRISE BLVD, SUITE 208, SUNRISE, FL, 333233207, US | |||||||||||||||||||
|
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| Phone | +1 954-851-9690 |
| Fax | 9548519688 |
Authorized person
| Name | MRS. VANESSA ROXANE LONG |
| Role | PMHNP, PRESIDENT |
| Phone | 9548519690 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | 9312887 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LONG VANESSA R | Agent | 14201 W SUNRISE BLVD, SUNRISE, FL, 33323 |
| Name | Role | Address |
|---|---|---|
| LONG VANESSA R | ARNP | 14201 W SUNRISE BLVD, SUNRISE, FL, 33323 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-15 | 14201 W SUNRISE BLVD, SUITE 208, SUNRISE, FL 33323 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-15 | 14201 W SUNRISE BLVD, SUITE 208, SUNRISE, FL 33323 | No data |
| REINSTATEMENT | 2016-11-01 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-11-01 | LONG, VANESSA R | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-12 | 14201 W SUNRISE BLVD, SUITE 208, SUNRISE, FL 33323 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-15 |
| ANNUAL REPORT | 2017-04-08 |
| REINSTATEMENT | 2016-11-01 |
| ANNUAL REPORT | 2015-02-01 |
| ANNUAL REPORT | 2014-01-18 |
| ANNUAL REPORT | 2013-03-24 |
| ANNUAL REPORT | 2012-04-12 |
| Domestic Profit | 2011-01-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
