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  5. RAPHA KIDNEY CENTER PLLC

RAPHA KIDNEY CENTER PLLC

Company Details

Entity Name: RAPHA KIDNEY CENTER PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 04 May 2018 (7 years ago)
Document Number: L18000113335
FEI/EIN Number 81-0977823
Address: 6218 W CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL, 34429, US
Mail Address: 6218 W CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL, 34429, US
ZIP code: 34429
County: Citrus
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972079713 2018-10-19 2020-08-31 PO BOX 141032, GAINESVILLE, FL, 326141032, US 1548B S WATER ST, STARKE, FL, 320914511, US

Contacts
Phone +1 352-346-3127
Fax 3525816226

Authorized person
Name OLUTAYO OLABIGE
Role OWNER
Phone 3523463127

Taxonomy
Taxonomy Code 207RN0300X - Nephrology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RAPHA KIDNEY CENTER 401(K) PLAN 2023 810977823 2024-05-13 RAPHA KIDNEY CENTER PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 6466238106
Plan sponsor’s address 3053 SW 115TH TER, GAINESVILLE, FL, 32608

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-13
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
RAPHA KIDNEY CENTER 401(K) PLAN 2022 810977823 2023-05-27 RAPHA KIDNEY CENTER PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 6466238106
Plan sponsor’s address 3053 SW 115TH TER, GAINESVILLE, FL, 32608

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-27
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
RAPHA KIDNEY CENTER 401(K) PLAN 2021 810977823 2022-06-02 RAPHA KIDNEY CENTER PLLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 6466238106
Plan sponsor’s address 3053 SW 115TH TER, GAINESVILLE, FL, 32608

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-06-02
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
RAPHA KIDNEY CENTER 401(K) PLAN 2020 810977823 2021-06-22 RAPHA KIDNEY CENTER PLLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3523463127
Plan sponsor’s address 3053 SW 115TH TER, GAINESVILLE, FL, 32608

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-06-22
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
OLABIGE OLUTAYO Agent 3053 SW 115TH TERRACE, GAINESVILLE, FL, 32608

Authorized Member

Name Role Address
OLABIGE OLUTAYO Dr. Authorized Member 3053 SW 115TH TERRACE, GAINESVILLE, FL, 32608

PRAC

Name Role Address
OLAYIOYE-OLABIGE OYERONKE R PRAC 6218 W CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL, 34429

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-04-24 6218 W CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL 34429 No data
CHANGE OF MAILING ADDRESS 2023-04-24 6218 W CORPORATE OAKS DRIVE, CRYSTAL RIVER, FL 34429 No data

Documents

Name Date
ANNUAL REPORT 2024-02-28
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-02-04
ANNUAL REPORT 2021-02-04
ANNUAL REPORT 2020-05-26
ANNUAL REPORT 2019-04-06
Florida Limited Liability 2018-05-04

Related by officers

OLAYIOYE-OLABIGE OYERONKE R

THE REDEEMED CHRISTIAN CHURCH OF GOD THRONE OF GRACE TABERNACLE INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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