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NATIONAL KIDNEY PARTNERS, LLC - Florida Company Profile

Company Details

Entity Name: NATIONAL KIDNEY PARTNERS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

NATIONAL KIDNEY PARTNERS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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: 02 Feb 2021 (4 years ago)
Document Number: L21000034201
FEI/EIN Number 59-3068073

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 14134 NEPHRON LANE, HUDSON, FL, 34467, US
Mail Address: 14134 NEPHRON LANE, HUDSON, FL, 34467, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780684795 2005-08-01 2024-04-24 14134 NEPHRON LANE, HUDSON, FL, 34667, US 14134 NEPHRON LN, HUDSON, FL, 346676504, US

Contacts

Phone +1 727-266-1403
Fax 7274976784
Phone +1 727-863-5418
Fax 7278698626

Authorized person

Name SHAWN ERIC BARNETT
Role CREDENTIALING AND COMPLIANCE MGR
Phone 7278635418

Taxonomy

Taxonomy Code 207RN0300X - Nephrology Physician
Is Primary Yes

Other Provider Identifiers

Issuer BLUE CROSS BLUE SHIELD
Number 24654
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NATIONAL KIDNEY PARTNERS 401(K) PLAN 2023 593068073 2024-09-13 NATIONAL KIDNEY PARTNERS 111
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4146413940
Plan sponsor’s address 14134 NEPHRON LANE, HUDSON, FL, 34667

Signature of

Role Plan administrator
Date 2024-09-13
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature
NATIONAL KIDNEY PARTNERS 401(K) PLAN 2023 593068073 2024-10-14 NATIONAL KIDNEY PARTNERS 111
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 4146413940
Plan sponsor’s address 14134 NEPHRON LANE, HUDSON, FL, 34667

Signature of

Role Plan administrator
Date 2024-10-14
Name of individual signing VANESSA URREGO
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
Shetye Kedar MD Manager 14134 Nephron Lane, Hudson, FL, 34667
Paxton Lani KMD Chief Executive Officer 14134 Nephron Lane, Hudson, FL, 34667
Brucculeri Michael MD Manager 14134 NEPHRON LANE, HUDSON, FL, 34467
DiPaolo Marc MD Comp 14134 NEPHRON LANE, HUDSON, FL, 34467
Mowen Kyle IT 14134 NEPHRON LANE, HUDSON, FL, 34467
Mowen Kyle Director 14134 NEPHRON LANE, HUDSON, FL, 34467
Shetye Kedar M.D. Agent 14134 NEPHRON LANE, HUDSON, FL, 34467

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2024-07-31 Shetye, Kedar, M.D. -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-07-31
ANNUAL REPORT 2024-04-26
ANNUAL REPORT 2023-09-01
ANNUAL REPORT 2022-07-26
Florida Limited Liability 2021-02-02

Date of last update: 01 Mar 2025

Sources: Florida Department of State