| Entity Name: | BRANDON ASSISTED LIVING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Sep 2015 (9 years ago) |
| Document Number: | L15000155719 |
| FEI/EIN Number | 47-5234043 |
| Address: | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 |
| Mail Address: | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 |
| ZIP code: | 33701 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518572866 | 2020-09-14 | 2020-09-14 | 1320 OAKFIELD DR, BRANDON, FL, 335114860, US | 1320 OAKFIELD DR, BRANDON, FL, 335114860, US | |||||||||||||||||||||
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| Phone | +1 941-362-4753 |
| Fax | 9413624766 |
Authorized person
| Name | LIZA ROJAS |
| Role | ADMINISTRATION |
| Phone | 9413624753 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AHCA |
| Number | AL13150 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PRIDGEN, GRADY C, III | Agent | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 |
| Name | Role | Address |
|---|---|---|
| PRIDGEN, GRADY C, III | Manager | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000130341 | TESSERA OF BRANDON | EXPIRED | 2017-11-29 | 2022-12-31 | No data | 1320 OAKFIELD DRIVE, BRANDON, FL, 33511 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-04-01 | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2025-04-01 | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 240 4TH STREET NORTH, ST PETERSBURG, FL 33701 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-06-25 |
| ANNUAL REPORT | 2019-03-27 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-02-17 |
| ANNUAL REPORT | 2016-03-17 |
| Florida Limited Liability | 2015-09-11 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
