| Entity Name: | ANDRADA GUERZON #1 CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 21 Oct 2003 (21 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P03000120007 |
| FEI/EIN Number | 16-1688560 |
| Address: | 815 WEST DAUGHTERY ROAD, LAKELAND, FL 33809 |
| Mail Address: | 7208 BEAKRUSH LANE, WINTER GARDEN, FL 34787 |
| ZIP code: | 33809 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740449263 | 2008-06-09 | 2008-06-09 | 815 W DAUGHTERY RD, LAKELAND, FL, 338093121, US | 815 W DAUGHTERY RD, LAKELAND, FL, 338093121, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-859-0475 |
| Fax | 8638590865 |
Authorized person
| Name | MRS. EDITHA ANDRADA |
| Role | OWNER |
| Phone | 8638590475 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL10535 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 687427400 |
| State | FL |
| Issuer | ACS |
| Number | 142291000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BENITEZ, GUS RESQ. | Agent | 1223 EAST CONCORD STREET, ORLANDO, FL 32803 |
| Name | Role | Address |
|---|---|---|
| ANDRADA, GREGORIO M | Director | 815 WEST DAUGHTERY RD., LAKELAND, FL 33809 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000023617 | GOLDEN GATE ASSISTED LIVING FACILITY | EXPIRED | 2011-03-04 | 2016-12-31 | No data | 815 WEST DAUGHTERY ROAD, LAKELAND, FL, 33809 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-12 | 815 WEST DAUGHTERY ROAD, LAKELAND, FL 33809 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-07-10 | 1223 EAST CONCORD STREET, ORLANDO, FL 32803 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-07-10 | BENITEZ, GUS RESQ. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-07-07 | 815 WEST DAUGHTERY ROAD, LAKELAND, FL 33809 | No data |
| CANCEL ADM DISS/REV | 2005-10-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-26 |
| ANNUAL REPORT | 2010-01-12 |
| Off/Dir Resignation | 2009-07-10 |
| Reg. Agent Change | 2009-07-10 |
| ANNUAL REPORT | 2009-04-28 |
| ANNUAL REPORT | 2008-01-21 |
| Off/Dir Resignation | 2007-11-08 |
| ANNUAL REPORT | 2007-04-26 |
| ANNUAL REPORT | 2006-07-07 |
| REINSTATEMENT | 2005-10-06 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
