| Entity Name: | WILLOW BAY HEALTH INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Jan 2012 (13 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 05 Jul 2023 (2 years ago) |
| Document Number: | P12000005622 |
| FEI/EIN Number | 45-4300291 |
| Address: | 4001 WEST HILLSBORO BLVD, DEERFIELD BEACH, FL, 33442 |
| Mail Address: | 4001 W Hillsboro Blvd, Deerfield Beach, FL, 33442, US |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962744276 | 2013-03-25 | 2013-03-25 | 7575 65TH WAY N, PINELLAS PARK, FL, 337813116, US | 7575 65TH WAY N, PINELLAS PARK, FL, 337813116, US | |||||||||||||||||||||
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| Phone | +1 727-329-8779 |
| Fax | 7273298638 |
Authorized person
| Name | MR. SOLOMON MATHEW |
| Role | MANAGER |
| Phone | 9549408555 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001564900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Mathew Annie | Agent | 4001 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| George Cyril | Director | 4001 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| ANNIE MATHEW, MATHEW BYPASS TRUS | Treasurer | 4001 WEST HILLSBORO BLVD, DEERFIELD BEACH, FL, 33442 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000037939 | WILLOW BAY SENIOR RESORT | ACTIVE | 2018-03-21 | 2028-12-31 | No data | 4001 WEST HILLSBORO BLVD, DEERFIELD BEACH, FL, 33442 |
| G12000046630 | WILLOW BAY SENIOR RESORT | EXPIRED | 2012-05-18 | 2017-12-31 | No data | 4001 WEST HILLSBORO BLVD, DEERFIELD BEACH, FL, 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-07-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-14 | Mathew, Annie | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-14 | 4001 W Hillsboro Blvd, Deerfield Beach, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-25 | 4001 WEST HILLSBORO BLVD, DEERFIELD BEACH, FL 33442 | No data |
| AMENDMENT | 2015-05-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-18 |
| Amendment | 2023-07-05 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-25 |
| AMENDED ANNUAL REPORT | 2021-06-22 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-22 |
| ANNUAL REPORT | 2017-03-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
