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YBOR CITY DIALYSIS, LLC - Florida Company Profile

Company Details

Entity Name: YBOR CITY DIALYSIS, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
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: 21 Jun 2007 (18 years ago)
Document Number: M07000003788
FEI/EIN Number 260460800

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

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

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205006228 2008-03-05 2023-10-17 5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN, 370277569, US 4204 N MACDILL AVE, STE 1B, NORTH BLDG, TAMPA, FL, 336076364, US

Contacts

Phone +1 615-320-4593
Fax 8002935872
Phone +1 813-872-8216
Fax 8138728469

Authorized person

Name SAMUEL T WEY
Role VP LICENSURE&CERTIFICATION
Phone 6153416641

Taxonomy

Taxonomy Code 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 001586100
State FL

Key Officers & Management

Name Role Address
TOTAL RENAL CARE, INC. Auth -
JAYESH S SHAH,MD LLC Auth -
Caldwell Samantha A Auth 2000 16th Street, Denver, CO, 80202
CORPORATION SERVICE COMPANY Agent -

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000088927 GREATER TAMPA AT HOME ACTIVE 2019-08-21 2029-12-31 - 4204 N. MACDILL AVE, SUITE 1B NORTH BLDG., TAMPA, FL, 33607
G08345900034 EAST TAMPA DIALYSIS EXPIRED 2008-12-08 2013-12-31 - 1701 E. 9TH AVENUE, YBOR CITY, FL, 33605
G08092900066 GREATER TAMPA AT HOME EXPIRED 2008-03-31 2013-12-31 - 4204 N. MACDILL AVE, TAMPA, FL, 33607

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-18 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 -
CHANGE OF MAILING ADDRESS 2024-04-18 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 -

Documents

Name Date
ANNUAL REPORT 2024-04-18
ANNUAL REPORT 2023-04-15
ANNUAL REPORT 2022-04-19
ANNUAL REPORT 2021-04-21
ANNUAL REPORT 2020-04-20
ANNUAL REPORT 2019-04-16
ANNUAL REPORT 2018-04-17
ANNUAL REPORT 2017-04-19
ANNUAL REPORT 2016-04-27
ANNUAL REPORT 2015-04-28

Date of last update: 03 Mar 2025

Sources: Florida Department of State