| Entity Name: | BORMEY ASSISTED LIVING FACILITIES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 Aug 2016 (8 years ago) |
| Document Number: | P16000071670 |
| FEI/EIN Number | 81-3809681 |
| Address: | 6416 AMBASSADOR DRIVE, TAMPA, FL, 33615 |
| Mail Address: | 6416 AMBASSADOR DRIVE, TAMPA, FL, 33615 |
| ZIP code: | 33615 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568999076 | 2017-05-15 | 2023-02-22 | 6416 AMBASSADOR DR, TAMPA, FL, 336153402, US | 6416 AMBASSADOR DR, TAMPA, FL, 336153402, US | |||||||||||||||||||||||||||
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| Phone | +1 813-512-8569 |
| Fax | 8135122576 |
| Fax | 8135128569 |
Authorized person
| Name | LISET RODRIGUEZ |
| Role | ADMINISTRATOR |
| Phone | 7862109669 |
Taxonomy
| Taxonomy Code | 310400000X - Assisted Living Facility |
| License Number | 13007 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020916400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BORMEY HAYDEE | Agent | 6416 AMBASSADOR DRIVE, TAMPA, FL, 33615 |
| Name | Role | Address |
|---|---|---|
| BORMEY HAYDEE | President | 6416 AMBASSADOR DRIVE, TAMPA, FL, 33615 |
| Name | Role | Address |
|---|---|---|
| Rodriguez Liset | Vice President | 6416 AMBASSADOR DRIVE, TAMPA, FL, 33615 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-01-10 |
| ANNUAL REPORT | 2022-02-09 |
| ANNUAL REPORT | 2021-02-12 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-05 |
| ANNUAL REPORT | 2018-02-13 |
| AMENDED ANNUAL REPORT | 2017-07-14 |
| ANNUAL REPORT | 2017-04-11 |
| Domestic Profit | 2016-08-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
