| Entity Name: | KIDNEY INSTITUTE OF NAPLES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Feb 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 06 Oct 2011 (13 years ago) |
| Document Number: | L05000013381 |
| FEI/EIN Number | 202573569 |
| Address: | 878 109TH AVE., N., NAPLES, FL, 34108 |
| Mail Address: | 878 109TH AVE., N., NAPLES, FL, 34108 |
| ZIP code: | 34108 |
| County: | Collier |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376579607 | 2006-06-26 | 2010-10-25 | 878 109TH AVE NO, NAPLES, FL, 341081821, US | 878 109TH AVE N, NAPLES, FL, 341081821, US | |||||||||||||||||||||
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| Phone | +1 239-596-3044 |
| Fax | 2395961395 |
Authorized person
| Name | MARK S RUSSO |
| Role | OWNER |
| Phone | 2395131002 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 892063000 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KIDNEY INSTITUTE OF NAPLES LLC 401(K) PLAN | 2012 | 202573569 | 2013-06-04 | KIDNEY INSTITUTE OF NAPLES | 2 | |||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-06-04 |
| Name of individual signing | LAUREEN MARINO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-06-04 |
| Name of individual signing | LAUREEN MARINO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-02-01 |
| Business code | 621492 |
| Sponsor’s telephone number | 2395963044 |
| Plan sponsor’s address | 878 109TH AVE N STE 1, NAPLES, FL, 341081821 |
Plan administrator’s name and address
| Administrator’s EIN | 202573569 |
| Plan administrator’s name | KIDNEY INSTITUTE OF NAPLES |
| Plan administrator’s address | 878 109TH AVE N STE 1, NAPLES, FL, 341081821 |
| Administrator’s telephone number | 2395963044 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-14 |
| Name of individual signing | LAUREEN MARINO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-05-14 |
| Name of individual signing | LAUREEN MARINO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MARK S RUSSO, MD, PHD | Agent | 878 109TH AVENUE NORTH, NAPLES, FL, 34108 |
| Name | Role | Address |
|---|---|---|
| MARK S RUSSO, MD, PHD | Managing Member | 878 109TH AVE., N., NAPLES, FL, 34108 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2011-10-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| LC AMENDMENT | 2010-10-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2010-10-08 | MARK S RUSSO, MD, PHD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-10-08 | 878 109TH AVENUE NORTH, NAPLES, FL 34108 | No data |
| CHANGE OF MAILING ADDRESS | 2010-09-29 | 878 109TH AVE., N., NAPLES, FL 34108 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-09-29 | 878 109TH AVE., N., NAPLES, FL 34108 | No data |
| AMENDMENT | 2005-04-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-03-07 |
| ANNUAL REPORT | 2021-01-19 |
| ANNUAL REPORT | 2020-02-17 |
| ANNUAL REPORT | 2019-03-13 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-03-16 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
