| Entity Name: | RAI CARE CENTERS OF FLORIDA I, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Aug 2005 (19 years ago) |
| Document Number: | M05000004505 |
| FEI/EIN Number | 20-3275837 |
| Address: | 920 WINTER STREET, WALTHAM, MA 02451 |
| Mail Address: | 920 WINTER STREET, WALTHAM, MA 02451 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932118932 | 2006-08-07 | 2023-10-17 | 29296 US HIGHWAY 19 N STE 1, CLEARWATER, FL, 337612104, US | 29296 US HIGHWAY 19 N STE 1, CLEARWATER, FL, 337612104, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 727-785-9036 |
| Fax | 7277728027 |
Authorized person
| Name | BARRY L. BLANTON |
| Role | VICE PRESIDENT |
| Phone | 7816999000 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 891164900 |
| State | FL |
| Issuer | BCBS |
| Number | V1Q |
| State | FL |
| Issuer | AETNA |
| Number | 5674393 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| RAI Care Centers Holdings I, LLC | MEMBER | 920 WINTER STREET, WALTHAM, MA 02451 |
| Name | Role | Address |
|---|---|---|
| Mello, Bryan | Asst. Treasurer | 920 WINTER STREET, WALTHAM, MA 02451 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000077428 | FRESENIUS KIDNEY CARE STARKEY LARGO | ACTIVE | 2022-06-28 | 2027-12-31 | No data | 12505 STARKEY RD, SUITE L AND M, LARGO, FL, 33773 |
| G17000052127 | FRESENIUS MEDICAL CARE CLEARWATER BEACH | ACTIVE | 2017-05-11 | 2027-12-31 | No data | 1057 S. FORT HARRISON AVE., CLEARWATER, FL, 33761 |
| G17000015802 | FMC CLEARWATER BEACH | EXPIRED | 2017-02-13 | 2022-12-31 | No data | 1057 S FORT HARRISON AVE, CLEARWATER, FL, 33761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-05 | 920 WINTER STREET, WALTHAM, MA 02451 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-10-18 | 920 WINTER STREET, WALTHAM, MA 02451 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-05 |
| ANNUAL REPORT | 2023-02-23 |
| ANNUAL REPORT | 2022-04-12 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-06-01 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-16 |
| ANNUAL REPORT | 2015-04-14 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
