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  5. FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.

FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. - Florida Company Profile

Company Details

Entity Name: FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 13 May 1977 (48 years ago)
Last Event: AMENDMENT
Event Date Filed: 08 Nov 2013 (11 years ago)
Document Number: 739018
FEI/EIN Number 591741273

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1926 Victoria Ave, FORT MYERS, FL, 33901, US
Mail Address: P.O. BOX 1357, FORT MYERS, FL, 33902
ZIP code: 33901
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1417661893 2023-01-10 2023-01-10 PO BOX 919771, ORLANDO, FL, 328919771, US 2450 EDISON AVE, FORT MYERS, FL, 339015127, US

Contacts
Phone +1 239-278-3600
Fax 2394795202

Authorized person
Name KRYSTLE CAMERON
Role CREDENTIALING ADMINISTRATOR
Phone 2393442391

Taxonomy
Taxonomy Code 261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary Yes

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300W0YBD8JXZE5M84 739018 US-FL GENERAL ACTIVE -

Addresses
Legal C/O Dr. Frank Mazzeo, Jr., 2256 Heitman Street, Fort Myers, US-FL, US, 33901
Headquarters 2256 Heitman Street, Fort Myers, US-FL, US, 33901

Registration details
Registration Date 2018-04-03
Last Update 2023-08-04
Status LAPSED
Next Renewal 2019-04-02
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 739018

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFITS PLAN OF FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 2012 591741273 2013-10-03 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 367
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-02-01
Business code 621498
Sponsor’s telephone number 2392783600
Plan sponsor’s mailing address P. O. BOX 1357, FORT MYERS, FL, 33903
Plan sponsor’s address 2256 HEITMAN STREET, FORT MYERS, FL, 33903

Number of participants as of the end of the plan year
Active participants 305
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 83
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 388
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 20

Signature of
Role Plan administrator
Date 2013-10-03
Name of individual signing JOHN KOEHLER
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 2011 591741273 2012-09-27 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 302
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-01-01
Business code 621498
Sponsor’s telephone number 2392783600
Plan sponsor’s mailing address P. O. BOX 1357, FORT MYERS, FL, 33902
Plan sponsor’s address 2256 HEITMAN STREET, FORT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 591741273
Plan administrator’s name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Plan administrator’s address P. O. BOX 1357, FORT MYERS, FL, 33902
Administrator’s telephone number 2392783600

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 116

Signature of
Role Plan administrator
Date 2012-09-27
Name of individual signing JOHN KOEHLER
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFITS PLAN OF SOUTHWEST FLORIDA, INC. 2011 591741273 2012-09-27 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-02-01
Business code 621498
Sponsor’s telephone number 2392783600
Plan sponsor’s mailing address P. O. BOX 1357, FORT MYERS, FL, 33902
Plan sponsor’s address 2256 HEITMAN STREET, FORT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 591741273
Plan administrator’s name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Plan administrator’s address P. O. BOX 1357, FORT MYERS, FL, 33902
Administrator’s telephone number 2392783600

Number of participants as of the end of the plan year
Active participants 283
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 84
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 367
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 21

Signature of
Role Plan administrator
Date 2012-09-27
Name of individual signing JOHN KOEHLER
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC. 2010 591741273 2011-09-21 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 288
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-01-01
Business code 621498
Sponsor’s telephone number 2392783600
Plan sponsor’s mailing address P. O. BOX 1357, FORT MYERS, FL, 33902
Plan sponsor’s address 2256 HEITMAN STREET, FORT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 591741273
Plan administrator’s name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Plan administrator’s address P. O. BOX 1357, FORT MYERS, FL, 33902
Administrator’s telephone number 2392783600

Number of participants as of the end of the plan year
Active participants 231
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 71
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 302
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 19

Signature of
Role Plan administrator
Date 2011-09-21
Name of individual signing JOHN KOEHLER
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 2009 591741273 2010-10-15 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 266
Three-digit plan number (PN) 001
Effective date of plan 1978-01-01
Business code 621498
Sponsor’s telephone number 2392783600
Plan sponsor’s mailing address P. O. BOX 1357, FORT MYERS, FL, 33902
Plan sponsor’s address 2256 HEITMAN STREET, FORT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 591741273
Plan administrator’s name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Plan administrator’s address P. O. BOX 1357, FORT MYERS, FL, 33902
Administrator’s telephone number 2392783600

Number of participants as of the end of the plan year
Active participants 220
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 68
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 288
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 30

Signature of
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing JOHN KOEHLER
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 2009 591741273 2010-10-15 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. 266
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1978-01-01
Business code 621498
Sponsor’s telephone number 2392783600
Plan sponsor’s mailing address P. O. BOX 1357, FORT MYERS, FL, 33902
Plan sponsor’s address 2256 HEITMAN STREET, FORT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 591741273
Plan administrator’s name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Plan administrator’s address P. O. BOX 1357, FORT MYERS, FL, 33902
Administrator’s telephone number 2392783600

Number of participants as of the end of the plan year
Active participants 220
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 68
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 288
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 30

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing JOHN KOEHLER
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
MAZZEO, JR. FRANK Dr. Chief Executive Officer 1926 Victoria Ave, FORT MYERS, FL, 33901
Epifanio Patricia Chairman 9755 Cattail Ct, FORT MYERS, FL, 33905
Hendry Beth Vice Chairman 7777 Woodbend Cricle, FORT MYERS, FL, 33912
Melhado Lolita Dr. Secretary 11948 Five Waters Circle, Fort myers, FL, 33913
Munzert Michael Treasurer 2134 Jeffrcott Street, Fort Myers, FL, 33901
Daniel Griffith Chief Financial Officer 10230 Ashbrook Court, Fort myers, FL, 33913
MAZZEO, JR. FRANK DR. Agent 1926 Victoria Ave, FORT MYERS, FL, 33901

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000005314 ELITE HEALTH CARE ACTIVE 2014-01-15 2029-12-31 - P.O. BOX 1357, FORT MYERS, FL, 33902
G11000069010 FIRST CHOICE KIDCARE ACTIVE 2011-07-11 2026-12-31 - P.O. BOX 1357, FORT MYERS, FL, 33902

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2024-04-04 1926 Victoria Ave, FORT MYERS, FL 33901 -
CHANGE OF PRINCIPAL ADDRESS 2023-03-30 1926 Victoria Ave, FORT MYERS, FL 33901 -
AMENDMENT 2013-11-08 - -
REGISTERED AGENT NAME CHANGED 2010-05-12 MAZZEO, JR., FRANK, DR. -
REINSTATEMENT 2005-10-10 - -
CHANGE OF MAILING ADDRESS 2005-10-10 1926 Victoria Ave, FORT MYERS, FL 33901 -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2005-09-16 - -
AMENDMENT 1992-08-03 - -
RESTATED ARTICLES 1992-08-03 - -
NAME CHANGE AMENDMENT 1991-03-25 FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. -

Documents

Name Date
ANNUAL REPORT 2024-04-04
ANNUAL REPORT 2023-03-30
ANNUAL REPORT 2022-03-18
ANNUAL REPORT 2021-01-14
ANNUAL REPORT 2020-03-25
ANNUAL REPORT 2019-03-18
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-15
ANNUAL REPORT 2016-03-24
ANNUAL REPORT 2015-01-12

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
C81CS14445 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-06-29 2011-06-28 ARRA - CAPITAL IMPROVEMENT PROGRAM
Recipient FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC
Recipient Name Raw FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA
Recipient UEI TQ4HN9SBD579
Recipient DUNS 084188598
Recipient Address P.O. BOX 1357, FORT MYERS, LEE, FLORIDA, 33902-1357, UNITED STATES
Obligated Amount 2262430.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H8BCS11595 Department of Health and Human Services 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS 2009-03-27 2011-03-26 ARRA - INCREASE SERVICES TO HEALTH CENTERS
Recipient FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC
Recipient Name Raw FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA
Recipient UEI TQ4HN9SBD579
Recipient DUNS 084188598
Recipient Address P.O. BOX 1357, FORT MYERS, LEE, FLORIDA, 33902-1357, UNITED STATES
Obligated Amount 902026.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
H80CS00185 Department of Health and Human Services 93.224 - CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, PUBLIC HOUSING PRIMARY CARE, AND SCHOOL BASED HEALTH CENTERS) 2002-01-01 2009-12-31 HEALTH CENTER CLUSTER
Recipient FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC
Recipient Name Raw FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA
Recipient UEI TQ4HN9SBD579
Recipient DUNS 084188598
Recipient Address POST OFFICE BOX 1357, FORT MYERS, LEE, FLORIDA, 33902
Obligated Amount 90116168.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-1741273 Corporation Unconditional Exemption PO BOX 1357, FT MYERS, FL, 33902-1357 1980-03
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 173060783
Income Amount 118553774
Form 990 Revenue Amount 118544816
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC
EIN 59-1741273
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8675518703 2021-04-07 0455 PPP 2256 Heitman St, Fort Myers, FL, 33901-3744
Loan Status Date 2021-10-09
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 5854482
Loan Approval Amount (current) 5854482
Undisbursed Amount 0
Franchise Name -
Lender Location ID 123987
Servicing Lender Name Cogent Bank
Servicing Lender Address 420 S Orange Ave, Ste 150, ORLANDO, FL, 32801
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Fort Myers, LEE, FL, 33901-3744
Project Congressional District FL-19
Number of Employees 500
NAICS code 621498
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type 501(c)3 � Non Profit
Originating Lender ID 123987
Originating Lender Name Cogent Bank
Originating Lender Address ORLANDO, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 5879038.3
Forgiveness Paid Date 2021-09-14

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Epifanio Patricia

TAB'ITHA TEMPLE NO135, DAUGHTERS OF THE NILE INC. - Active
Domestic Non-Profit (2013 )

Companies related by address

No other companies in our directory share the same address as FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.

Date of last update: 03 Apr 2025

Sources: Florida Department of State

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