| Entity Name: | WILLSAND HOME HEALTH AGENCY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Jul 2000 (25 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P00000066025 |
| FEI/EIN Number | 651022805 |
| Address: | 9621 SW 40TH ST, MIAMI, FL, 33165 |
| Mail Address: | 9621 SW 40TH ST, MIAMI, FL, 33165 |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003849530 | 2006-07-08 | 2009-06-03 | 9621 SW 40TH ST, MIAMI, FL, 331654030, US | 9621 SW 40TH ST, MIAMI, FL, 331654030, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-871-5511 |
| Fax | 3058716611 |
Authorized person
| Name | MR. EULISES ESCALONA |
| Role | CEO |
| Phone | 3058715511 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991519 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 651056600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ESCALONA EULISES | Agent | 9621 SW 40TH ST, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| ESCALONA EULISES | President | 9621 SW 40TH ST, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| ESCALONA EULISES | Vice Treasurer | 9621 SW 40TH ST, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| ESCALONA EULISES | Director | 9621 SW 40TH ST, MIAMI, FL, 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-02-27 | 9621 SW 40TH ST, MIAMI, FL 33165 | No data |
| CHANGE OF MAILING ADDRESS | 2009-02-27 | 9621 SW 40TH ST, MIAMI, FL 33165 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-27 | 9621 SW 40TH ST, MIAMI, FL 33165 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-01-16 | ESCALONA, EULISES | No data |
| AMENDMENT | 2003-05-12 | No data | No data |
| AMENDMENT | 2000-07-24 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001791632 | LAPSED | 1000000554222 | COLUMBIA | 2013-11-18 | 2023-12-26 | $ 906.68 | STATE OF FLORIDA0017243 |
| J13001793216 | LAPSED | 1000000554514 | COLUMBIA | 2013-11-18 | 2023-12-26 | $ 2,100.24 | STATE OF FLORIDA0100330 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2011-04-27 |
| ANNUAL REPORT | 2010-04-28 |
| ANNUAL REPORT | 2009-02-27 |
| ANNUAL REPORT | 2008-04-23 |
| ANNUAL REPORT | 2007-03-08 |
| ANNUAL REPORT | 2006-01-16 |
| ANNUAL REPORT | 2005-03-28 |
| ANNUAL REPORT | 2004-04-05 |
| Amendment | 2003-05-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
