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A BANYAN RESIDENCE AT WILDWOOD LLC - Florida Company Profile

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Company Details

Entity Name: A BANYAN RESIDENCE AT WILDWOOD LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 02 May 2019 (6 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 05 Jun 2019 (6 years ago)
Document Number: L19000119297
FEI/EIN Number 83-4722083
Address: 12427 County Road 101, Oxford, FL, 34484, US
Mail Address: 12427 County Road 101, Oxford, FL, 34484, US
ZIP code: 34484
City: Oxford
County: Sumter
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Anderson Greg A Manager 3940 Bay Shore Road, Sarasota, FL, 342345209
Anderson Greg Manager 3940 Bay Shore Road, Sarasota, FL, 342345209
ANDERSON GREG A Agent 3940 Bay Shore Rd, Sarasota, FL, 34234

National Provider Identifier

NPI Number:
1083201891
Certification Date:
2020-12-28

Authorized Person:

Name:
GREG ANDERSON
Role:
MANAGING MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
310400000X - Assisted Living Facility
Is Primary:
Yes

Contacts:

Fax:
9414124749

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2025-01-06 3940 Bay Shore Rd, Sarasota, FL 34234 -
CHANGE OF MAILING ADDRESS 2022-10-24 12427 County Road 101, Oxford, FL 34484 -
REGISTERED AGENT ADDRESS CHANGED 2022-10-24 12427 County Road 101, Oxford, FL 34484 -
CHANGE OF PRINCIPAL ADDRESS 2020-12-18 12427 County Road 101, Oxford, FL 34484 -
LC AMENDMENT 2019-06-05 - -

Documents

Name Date
ANNUAL REPORT 2025-01-06
ANNUAL REPORT 2024-01-05
ANNUAL REPORT 2023-01-23
AMENDED ANNUAL REPORT 2022-10-24
ANNUAL REPORT 2022-03-09
AMENDED ANNUAL REPORT 2021-07-14
ANNUAL REPORT 2021-01-28
AMENDED ANNUAL REPORT 2020-12-18
ANNUAL REPORT 2020-03-24
LC Amendment 2019-06-05

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Date of last update: 03 Jul 2025

Sources: Florida Department of State