| Entity Name: | SANDCASTLE CARE V LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Oct 2020 (4 years ago) |
| Document Number: | L20000310149 |
| FEI/EIN Number | 853138148 |
| Mail Address: | PO BOX 90, WINTER PARK, FL, 32790, US |
| Address: | 13940 N US HIGHWAY 441, Lady Lake, FL, 32159, US |
| ZIP code: | 32159 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417564691 | 2020-09-30 | 2022-08-03 | PO BOX 90, WINTER PARK, FL, 327900090, US | 13940 N US HIGHWAY 441 STE 903, LADY LAKE, FL, 321598954, US | |||||||||||||||||||||||||
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| Fax | 8885052782 |
| Phone | +1 527-720-0113 |
Authorized person
| Name | ALEXANDER CASTILLO |
| Role | PRESIDENT |
| Phone | 4074544892 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 253Z00000X - In Home Supportive Care Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 112246900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CASTILLO ALEXANDER | Agent | 7346 COOK LANE, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| Castillo Adriana M | Manager | 7346 COOK LANE, WINTER PARK, FL, 32792 |
| CASTILLO ADRIANA M | Manager | 7346 COOK LN, WINTER PARK, FL, 32792 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000132295 | SANDCASTLE HOMECARE | ACTIVE | 2020-10-12 | 2025-12-31 | No data | PO BOX 90, WINTER PARK, FL, 32790 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-10-03 | 13940 N US HIGHWAY 441, SUITE 903, Lady Lake, FL 32159 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-24 | 7346 COOK LANE, WINTER PARK, FL 32792 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-27 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-03-24 |
| Florida Limited Liability | 2020-10-01 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
