| Entity Name: | AVALON PARK RETIREMENT RESIDENCE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Aug 2007 (17 years ago) |
| Document Number: | P07000090767 |
| FEI/EIN Number | 260759524 |
| Address: | 604 N 62 AVE., HOLLYWOOD, FL, 33024 |
| Mail Address: | 604 N 62ND AVENUE, HOLLYWOOD, FL, 33024 |
| ZIP code: | 33024 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669632857 | 2008-06-11 | 2008-06-11 | 600 N 62ND AVE, HOLLYWOOD, FL, 330247857, US | 600 N 62ND AVE, HOLLYWOOD, FL, 330247857, US | |||||||||||||||||||||||||
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| Phone | +1 954-981-4822 |
| Fax | 9549639561 |
Authorized person
| Name | MRS. MAGGIE KULNICK |
| Role | VP |
| Phone | 9549814822 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | AL6653 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 693228200 |
| State | FL |
| Name | Role |
|---|---|
| AVALON-PARK, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| KULNICK MAGDALENA | Vice President | 604 N 62 AVE., HOLLYWOOD, FL, 33024 |
| Name | Role | Address |
|---|---|---|
| KULNICK ANDREW | President | 604 N 62 AVE., HOLLYWOOD, FL, 33024 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2011-04-26 | AVALON PARK | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-05-11 | 604 N 62 AVE., HOLLYWOOD, FL 33024 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-05-11 | 604 N 62 AVE., HOLLYWOOD, FL 33024 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-07-28 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-29 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
