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ST. PETERSBURG KIDNEY CARE, LLC - Florida Company Profile

Company Details

Entity Name: ST. PETERSBURG KIDNEY CARE, 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: 08 Jul 2011 (14 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 17 May 2022 (3 years ago)
Document Number: M11000003458
FEI/EIN Number 45-2744287

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

Address: 500 Cummings Center, Suite 6550, Beverly, MA, 01915, US
Mail Address: Webb Plaza 810 Third Avenue South, St. Petersburg, FL, 33701, US
Place of Formation: DELAWARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326314295 2012-03-26 2023-01-14 800 3RD AVE S, WEBB PLAZA, ST PETERSBURG, FL, 337014010, US 800 3RD AVE S, WEBB PLAZA, ST PETERSBURG, FL, 337014010, US

Contacts

Phone +1 727-821-3201
Fax 7278213140

Authorized person

Name SARA ANNE BRADY
Role CHIEF NURSING OFFICER
Phone 2083717878

Taxonomy

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

Other Provider Identifiers

Issuer MEDICAID
Number 006736000
State FL

Key Officers & Management

Name Role Address
Attmore George Manager 500 Cummings Center, Beverly, MA, 01915
Fabelo Edward Manager 500 Cummings Center, Beverly, MA, 01915
Kamal Syed T Manager 500 Cummings Center, Beverly, MA, 01915
Praserthdam Manus M.D. Manager 500 Cummings Center, Beverly, MA, 01915
AAA CARE LLC Member -
AMERICAN RENAL ASSOCIATES LLC Member -
CORPORATION SERVICE COMPANY Agent -

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G22000152671 ST. PETERSBURG KIDNEY CENTER ACTIVE 2022-12-12 2027-12-31 - 500 CUMMINGS CENTER, SUITE 6550, BEVERLY, MA, 01915

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-02-20 500 Cummings Center, Suite 6550, Beverly, MA 01915 -
LC STMNT OF RA/RO CHG 2022-05-17 - -
REGISTERED AGENT NAME CHANGED 2022-05-17 CORPORATION SERVICE COMPANY -
REGISTERED AGENT ADDRESS CHANGED 2022-05-17 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 -
CHANGE OF PRINCIPAL ADDRESS 2021-04-17 500 Cummings Center, Suite 6550, Beverly, MA 01915 -

Documents

Name Date
ANNUAL REPORT 2025-01-28
ANNUAL REPORT 2024-02-23
ANNUAL REPORT 2023-02-20
CORLCRACHG 2022-05-17
ANNUAL REPORT 2022-03-29
ANNUAL REPORT 2021-04-17
ANNUAL REPORT 2020-06-04
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-04-06
ANNUAL REPORT 2017-04-18

Date of last update: 03 Apr 2025

Sources: Florida Department of State