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  5. BOCA GRANDE HEALTH CLINIC, INC.

BOCA GRANDE HEALTH CLINIC, INC.

Company Details

Entity Name: BOCA GRANDE HEALTH CLINIC, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 30 Dec 1963 (61 years ago)
Document Number: 706625
FEI/EIN Number 590966089
Address: 320 PARK AVENUE, BOCA GRANDE, FL, 33921, US
Mail Address: PO BOX 517, BOCA GRANDE, FL, 33921, US
ZIP code: 33921
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972683910 2006-10-16 2021-06-30 PO BOX 517, BOCA GRANDE, FL, 33921, US 320 PARK AVENUE, BOCA GRANDE, FL, 33921, US

Contacts
Phone +1 941-964-2276
Fax 9419640158

Authorized person
Name MR. JONNA FOOS
Role OPERATIONS COORDINATOR
Phone 9419642276

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOCA GRANDE HEALTH CLINIC 401(K) PLAN 2022 590966089 2024-01-04 BOCA GRANDE HEALTH CLINIC, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address PO BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC 401(K) PLAN 2021 590966089 2023-02-06 BOCA GRANDE HEALTH CLINIC, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address PO BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC 401(K) PLAN 2020 590966089 2022-07-12 BOCA GRANDE HEALTH CLINIC, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1997-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address PO BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC RETIREMENT PLAN 2019 590966089 2020-11-18 BOCA GRANDE HEALTH CLINIC. INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC, INC. RETIREMENT PLAN 2018 590966089 2019-12-11 BOCA GRANDE HEALTH CLINIC, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC, INC. RETIREMENT PLAN 2017 590966089 2018-12-19 BOCA GRANDE HEALTH CLINIC, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC, INC. RETIREMENT PLAN 2016 590966089 2018-01-29 BOCA GRANDE HEALTH CLINIC, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921
BOCA GRANDE HEALTH CLINIC, INC. RETIREMENT PLAN 2015 590966089 2017-01-04 BOCA GRANDE HEALTH CLINIC, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921

Signature of
Role Plan administrator
Date 2017-01-04
Name of individual signing HILJA BILODEAU
Valid signature Filed with authorized/valid electronic signature
BOCA GRANDE HEALTH CLINIC, INC. RETIREMENT PLAN 2014 590966089 2016-02-02 BOCA GRANDE HEALTH CLINIC, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921

Signature of
Role Plan administrator
Date 2016-02-02
Name of individual signing JOHN SIELERT
Valid signature Filed with authorized/valid electronic signature
BOCA GRANDE HEALTH CLINIC, INC. RETIREMENT PLAN 2013 590966089 2014-12-17 BOCA GRANDE HEALTH CLINIC, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-10-01
Business code 621498
Sponsor’s telephone number 9419642276
Plan sponsor’s address P.O. BOX 517, BOCA GRANDE, FL, 33921

Signature of
Role Plan administrator
Date 2014-12-17
Name of individual signing JOHN SIELERT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JENNINGS todd AESQ. Agent 625 COURT STREET, CLEARWATER, FL, 33756

Director

Name Role Address
May James Director PO BOX 517, BOCA GRANDE, FL, 33921
Ambrosius Mark Director 320 PARK AVENUE, BOCA GRANDE, FL, 33921
O'Bannon Mary Director 320 PARK AVENUE, BOCA GRANDE, FL, 33921
Skinner Mary Director 320 PARK AVENUE, BOCA GRANDE, FL, 33921
Cowan Holly Director 320 PARK AVENUE, BOCA GRANDE, FL, 33921

Vice Chairman

Name Role Address
Bowers Thomas Vice Chairman 320 PARK AVENUE, BOCA GRANDE, FL, 33921

Events

Event Type Filed Date Value Description
AMENDED AND RESTATEDARTICLES 2022-03-10 No data No data
AMENDMENT 2010-02-15 No data No data
RESTATED ARTICLES 1993-08-04 No data No data
AMENDMENT 1993-08-04 No data No data
AMENDMENT 1991-06-28 No data No data
AMENDMENT 1991-06-25 No data No data
AMENDMENT 1989-06-27 No data No data
RESTATED ARTICLES 1989-06-27 No data No data
AMENDMENT 1989-03-09 No data No data
AMENDMENT 1986-04-17 No data No data

Related by officers

May James

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Skinner Mary

MANDARIN PLACE NEIGHBORHOOD ASSOCIATION, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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