| Entity Name: | ANDERSON HEALTHCARE MASTERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Jul 2020 (5 years ago) |
| Document Number: | L20000200773 |
| FEI/EIN Number | 852067101 |
| Address: | 7643 GATE PARKWAY, SUITE 104-523, JACKSONVILLE, FL, 32256, US |
| Mail Address: | 7643 GATE PARKWAY, SUITE 104-523, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033729546 | 2020-08-10 | 2024-03-04 | 7643 GATE PKWY STE 104-523, JACKSONVILLE, FL, 322563092, US | 3390 KORI RD, JACKSONVILLE, FL, 322572419, US | |||||||||||||||
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| Fax | 9042533492 |
| Phone | +1 904-638-3511 |
Authorized person
| Name | TANISHA ANDERSON |
| Role | APRN |
| Phone | 9049091227 |
Taxonomy
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AQUALIT HEALTH 401(K) PLAN | 2023 | 852067101 | 2024-07-22 | ANDERSON HEALTHCARE MASTERS LLC | 5 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-22 |
| Name of individual signing | CHRIS HORNE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| NORTHWEST REGISTERED AGENT LLC | Agent |
| Name | Role | Address |
|---|---|---|
| ANDERSON TANISHA E | Manager | 7643 GATE PARKWAY SUITE 104-523, JACKSONVILLE, FL, 32256 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000033396 | AQUALIT MEDICAL EXAMS | ACTIVE | 2022-03-14 | 2027-12-31 | No data | 7643 GATE PARKWAY, SUITE 104-523, JACKSONVILLE, FL, 32256 |
| G21000066227 | AQUALIT HEALTH | ACTIVE | 2021-05-14 | 2026-12-31 | No data | 7643 GATE PARKWAY, SUITE 104-523, JACKSONVILLE, FL, 32256 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-26 |
| Florida Limited Liability | 2020-07-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
