| Entity Name: | HEALTH CHOICE NETWORK OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 28 Jun 1994 (31 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 04 Aug 2009 (16 years ago) |
| Document Number: | N94000003230 |
| FEI/EIN Number | 65-0504316 |
| Address: | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Mail Address: | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689322547 | 2022-03-10 | 2022-03-10 | 9064 NW 13TH TER, DORAL, FL, 331722907, US | 9064 NW 13TH TER, DORAL, FL, 331722907, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 305-418-9646 |
Authorized person
| Name | BLANCA MARGARITA OLLET |
| Role | COO |
| Phone | 7862556633 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GUARDIAN DENTAL | 2010 | 650504316 | 2012-01-26 | HEALTH CHOICE NETWORK OF FLORIDA, INC | 160 | |||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 650504316 |
| Plan administrator’s name | HEALTH CHOICE NETWORK OF FLORIDA, INC |
| Plan administrator’s address | 9064 NW 13 TH TERRACE, MIAMI, FL, 33172 |
| Administrator’s telephone number | 3055991015 |
Number of participants as of the end of the plan year
| Active participants | 160 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
Signature of
| Role | Plan administrator |
| Date | 2012-01-26 |
| Name of individual signing | RUSSELL HUZIOR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1995-10-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 3055991015 |
| Plan sponsor’s mailing address | 9064 NW13TH TERRACE, MIAMI, FL, 33172 |
| Plan sponsor’s address | 9064 NW13TH TERRACE, MIAMI, FL, 33172 |
Plan administrator’s name and address
| Administrator’s EIN | 650504316 |
| Plan administrator’s name | HEALTH CHOICE NETWORK OF FLORIDA, INC |
| Plan administrator’s address | 9064 NW13TERRACE, MIAMI, FL, 33172 |
| Administrator’s telephone number | 3055991015 |
Number of participants as of the end of the plan year
| Active participants | 123 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 32 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 155 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 9 |
Signature of
| Role | Plan administrator |
| Date | 2012-02-09 |
| Name of individual signing | RUSSELL HUZIOR |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Romillo, Alejandro | Agent | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Romillo, Alejandro | Chief Executive Officer | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Perez, Claudio | Vice Chairman | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Name | Role | Address |
|---|---|---|
| NEASMAN, ANNIE | Secretary | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Dorso, Elodie | Chairman | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Name | Role | Address |
|---|---|---|
| Hoback, Sherry | Treasurer | 9064 N.W. 13 TERRACE, DORAL, FL 33172 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000022364 | SOUTH FLORIDA REGIONAL EXTENSION CENTER | EXPIRED | 2010-03-08 | 2015-12-31 | No data | 9064 NW 13 TERRACE, MIAMI, FL, 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2016-04-26 | Romillo, Alejandro | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-18 | 9064 N.W. 13 TERRACE, DORAL, FL 33172 | No data |
| AMENDMENT AND NAME CHANGE | 2009-08-04 | HEALTH CHOICE NETWORK OF FLORIDA, INC. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-07-11 | 9064 N.W. 13 TERRACE, DORAL, FL 33172 | No data |
| CHANGE OF MAILING ADDRESS | 2006-07-11 | 9064 N.W. 13 TERRACE, DORAL, FL 33172 | No data |
| AMENDMENT | 2002-07-10 | No data | No data |
| AMENDED AND RESTATEDARTICLES | 1995-07-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000221639 | TERMINATED | 1000000578396 | LEE | 2014-01-27 | 2034-02-21 | $ 102,095.93 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, FORT MYERS SERVICE CENTER, 2295 VICTORIA AVE STE 270, FORT MYERS FL339013871 |
| J14000082577 | TERMINATED | 1000000570137 | MIAMI-DADE | 2014-01-10 | 2034-01-15 | $ 4,872.52 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| J13001805697 | TERMINATED | 1000000557370 | MIAMI-DADE | 2013-12-16 | 2033-12-26 | $ 2,144.18 | STATE OF FLORIDA0124741 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-04-22 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-04-24 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
