| Entity Name: | ISD RENAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Active |
| Date Filed: | 05 May 2005 (20 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 12 Oct 2011 (13 years ago) |
| Document Number: | F05000002767 |
| FEI/EIN Number | 202694671 |
| Address: | 2000 16th Street, JLD/SecGovFin, Denver, CO, 80202, US |
| Mail Address: | 601 Hawaii Street, JLD/SecGovFin, El Segundo, CA, 90245, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740235001 | 2006-05-24 | 2020-04-20 | 5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN, 370277569, US | 8470 COOPER CREEK BLVD, UNIVERSITY PARK, FL, 342012020, US | |||||||||||||||||||||||||
|
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| Phone | +1 615-320-4593 |
| Fax | 8002935872 |
| Phone | +1 941-359-0676 |
| Fax | 9413587012 |
Authorized person
| Name | JOHN D WINSTEL |
| Role | CHIEF ACCOUNTING OFFICER |
| Phone | 2537334501 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022822600 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Caldwell Samantha A | Auth | 2000 16th Street, Denver, CO, 80202 |
| Name | Role | Address |
|---|---|---|
| Staffieri Michael D | Director | 2000 16th Street, Denver, CO, 80202 |
| Name | Role | Address |
|---|---|---|
| Berry Christopher M | Treasurer | 2000 16th Street, Denver, CO, 80202 |
| Name | Role | Address |
|---|---|---|
| Berberich Stephanie N | Secretary | 2000 16th Street, Denver, CO, 80202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000117810 | LAKEWOOD RANCH DIALYSIS | EXPIRED | 2017-10-25 | 2022-12-31 | No data | 8470 COOPER CREEK BLVD, UNIVERSITY PARK, FL, 34201 |
| G17000117852 | NAPLES RENAL CENTER | ACTIVE | 2017-10-25 | 2027-12-31 | No data | 6625 HILLWAY CIRCLE, ATTN: JLD/SECGOVFIN., NAPLES, FL, 34112 |
| G12000009073 | COLLIER COUNTY DIALYSIS | EXPIRED | 2012-01-26 | 2017-12-31 | No data | 6625 HILLWAY CIRCLE, NAPLES, FL, 34112 |
| G12000009072 | MANATEE COUNTY DIALYSIS | EXPIRED | 2012-01-26 | 2017-12-31 | No data | 8131 COOPER CREEK BLVD., UNIVERSITY PARK, FL, 34201 |
| G11000104461 | NAPLES RENAL CENTER | EXPIRED | 2011-10-25 | 2016-12-31 | No data | 601 HAWAII STREET, EL SANGUNDO, CA, 90245 |
| G11000104468 | LAKEWOOD RANCH DIALYSIS | EXPIRED | 2011-10-25 | 2016-12-31 | No data | 601 HAWAII STREET, EL SEGUNDO, CA, 90245 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-19 | 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-19 | 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 | No data |
| NAME CHANGE AMENDMENT | 2011-10-12 | ISD RENAL, INC. | No data |
| REGISTERED AGENT NAME CHANGED | 2008-08-25 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-08-25 | 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 | No data |
| NAME CHANGE AMENDMENT | 2006-05-15 | DSI RENAL, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-23 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
