| Entity Name: | A. SUSAN NELSON ARNP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Jul 1999 (26 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: | P99000066925 |
| FEI/EIN Number | 650946606 |
| Address: | 1711 NW FEDERAL HWY., STUART, FL, 34994 |
| Mail Address: | 3098 SE BUR STREET, PORT ST. LUCIE, FL, 34952 |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265699854 | 2008-05-21 | 2008-05-21 | 3098 SE BUR ST, PORT SAINT LUCIE, FL, 349525855, US | 1711 NW FEDERAL HWY, STUART, FL, 349949631, US | |||||||||||||||||||||||||
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| Phone | +1 772-692-3140 |
| Fax | 7726923144 |
Authorized person
| Name | DR. A SUSAN NELSON |
| Role | CLINICAL NURSE SPECIALIST |
| Phone | 7726923140 |
Taxonomy
| Taxonomy Code | 364SP0809X - Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | 3039062 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 302409100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NELSON A. SUSAN | Agent | 3098 SE BUR STREET, PORT ST. LUCIE, FL, 34952 |
| Name | Role | Address |
|---|---|---|
| NELSON A. SUSAN | PhD | 3098 SE BUR STREET, PORT ST. LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-06-16 | 1711 NW FEDERAL HWY., STUART, FL 34994 | No data |
| CANCEL ADM DISS/REV | 2004-10-21 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-05-03 |
| ANNUAL REPORT | 2014-05-01 |
| ANNUAL REPORT | 2013-04-14 |
| ANNUAL REPORT | 2012-03-22 |
| ANNUAL REPORT | 2011-04-25 |
| ANNUAL REPORT | 2010-02-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
