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  5. FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC.

FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC.

Company Details

Entity Name: FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 19 Aug 2013 (11 years ago)
Document Number: N13000007411
FEI/EIN Number 46-3502696
Address: 4615 Philips Highway, Jacksonville, FL 32207
Mail Address: PO Box 352658, Palm Coast, FL 32135
ZIP code: 32207
County: Duval
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 2020 463502696 2021-04-14 FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-07-01
Business code 624100
Sponsor’s telephone number 7865206938
Plan sponsor’s address 2103 CORAL WAY 2ND FL, CORAL GABLES, FL, 331452601

Signature of
Role Plan administrator
Date 2021-04-14
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 2020 463502696 2021-07-22 FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-07-01
Business code 624100
Sponsor’s telephone number 7865206938
Plan sponsor’s address 2103 CORAL WAY 2ND FL, CORAL GABLES, FL, 331452601

Signature of
Role Plan administrator
Date 2021-04-14
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 2019 463502696 2021-04-14 FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-07-01
Business code 624100
Sponsor’s telephone number 7865206938
Plan sponsor’s address 2103 CORAL WAY 2ND FL, CORAL GABLES, FL, 331452601

Signature of
Role Plan administrator
Date 2021-04-14
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN 2017 463502696 2018-07-26 FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 813000
Sponsor’s telephone number 7865206938
Plan sponsor’s address 2103 CORAL WAY 2ND FL, CORAL GABLES, FL, 331452601

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-26
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 2016 463502696 2017-07-27 FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-07-01
Business code 624100
Sponsor’s telephone number 7274348506
Plan sponsor’s address PO BOX 977, ST PETERSBURG, FL, 337310977

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-27
Name of individual signing NICHOLAS DURAN
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS INC. 2015 463502696 2016-07-29 FLORIDA ASSOCIATION OF FREE AND CHARITABLE CLINICS, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-07-01
Business code 813910
Sponsor’s telephone number 7274348506
Plan sponsor’s address PO BOX 977, ST PETERSBURG, FL, 33731

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing NICHOLAS X. DURAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DeLorenzo, Rebecca Agent 4615 Philips Highway, Jacksonville, FL 32207

Chief Executive Officer

Name Role Address
DeLorenzo, Rebecca Chief Executive Officer 4615 Philips Highway, Jacksonville, FL 32207

Immediate Past Board Chair

Name Role Address
Papadimitriou, George Immediate Past Board Chair 2100 W. 45th Street, Suite A-8/9 West Palm Beach, FL 33407

Secretary

Name Role Address
Roberts, Tim Secretary 150 Beach Drive, Destin, FL 32541

Vice Chair

Name Role Address
Alvarez, Mario Vice Chair 750 NW 20th St, G-110 Miami, FL 33127

Board Chair

Name Role Address
Bueker , Jami Board Chair 4615 Philips Highway, Jacksonville, FL 32207

Treasurer

Name Role Address
Ryan, Jennifer Treasurer 41 E DUVAL STREET, JACKSONVILLE, FL 32202

Director

Name Role Address
Anderson, Fredrick, Dr. Director 11200 SW 8th Street, Miami, FL 33199
Gutierrez, Pete, Dr. Director 2015 NW 1st Ave, Miami, FL 33127
Johnston, Michael Director 1718 E Olive Rd, Pensacola, FL 32514
Hatch, Lisa Director 3855 S. US Hwy 1, Suite B Fort Pierce, FL 34982
Cunningham, Michael Director 5800 Overseas Highway, #38 Marathon, FL 33050
Maisonet, Jezabel Director 8645 W. Boynton Beach Blvd., Boynton Beach, FL 33472
Garris, Stephanie Director 1417 E. Concord Street, Orlando, FL 32803

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000078541 FAFCC, INC. ACTIVE 2023-06-30 2028-12-31 No data PO BOX 352658, PALM COAST, FL, 32135

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-01-19 4615 Philips Highway, Jacksonville, FL 32207 No data
CHANGE OF MAILING ADDRESS 2022-01-19 4615 Philips Highway, Jacksonville, FL 32207 No data
REGISTERED AGENT NAME CHANGED 2022-01-19 DeLorenzo, Rebecca No data
REGISTERED AGENT ADDRESS CHANGED 2022-01-19 4615 Philips Highway, Jacksonville, FL 32207 No data

Documents

Name Date
ANNUAL REPORT 2024-02-12
ANNUAL REPORT 2023-02-01
ANNUAL REPORT 2022-01-19
AMENDED ANNUAL REPORT 2021-07-21
ANNUAL REPORT 2021-05-03
ANNUAL REPORT 2020-04-24
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-04-23
Reg. Agent Change 2017-09-21
ANNUAL REPORT 2017-02-09

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Related by address

No related companies by address

Date of last update: 22 Jan 2025

Sources: Florida Department of State

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