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  5. BONITA COMMUNITY HEALTH CENTER, INC.

BONITA COMMUNITY HEALTH CENTER, INC.

Company Details

Entity Name: BONITA COMMUNITY HEALTH CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 27 Jul 1998 (27 years ago)
Last Event: AMENDED AND RESTATED ARTICLES
Event Date Filed: 30 Oct 2024 (3 months ago)
Document Number: N98000004321
FEI/EIN Number 59-3544102
Address: 3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135
Mail Address: PO BOX 2218, FORT MYERS, FL 33902
ZIP code: 34135
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1760459762 2006-03-08 2019-04-03 3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL, 341358127, US 3501 HEALTH CENTER BLVD, ESTERO, FL, 341358127, US

Contacts
Phone +1 239-949-1050

Authorized person
Name MR. MICHAEL RILEY
Role CEO
Phone 2399491050

Taxonomy
Taxonomy Code 208100000X - Physical Medicine & Rehabilitation Physician
License Number PT 21826
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS FLORIDA
Number 45737
State FL

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300U6DEWPQYNGHM93 N98000004321 US-FL GENERAL ACTIVE No data

Addresses
Legal C/O Cooper, Kevin, 350 7th Street North, Naples, US-FL, US, 34102
Headquarters 3501 Health Center Boulevard, Bonita Springs, US-FL, US, 34135

Registration details
Registration Date 2013-09-25
Last Update 2023-08-04
Status LAPSED
Next Renewal 2014-09-20
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As N98000004321

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BONITA COMMUNITY HEALTH CENTER 2019 593544102 2020-12-01 BONITA COMMUNITY HEALTH CENTER, INC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399496115
Plan sponsor’s address 3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2020-12-01
Name of individual signing MICHAEL D WAITE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-12-01
Name of individual signing MICHAEL D WAITE
Valid signature Filed with incorrect/unrecognized electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2019 593544102 2020-06-09 BONITA COMMUNITY HEALTH CENTER, INC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2020-06-09
Name of individual signing MICHAEL D. WAITE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-06-09
Name of individual signing MICHAEL D. WAITE
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2018 593544102 2019-08-21 BONITA COMMUNITY HEALTH CENTER, INC 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2019-08-21
Name of individual signing SARA M MCCALLUM
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2017 593544102 2018-07-11 BONITA COMMUNITY HEALTH CENTER, INC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2018-07-11
Name of individual signing SARA M MCCALLUM
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2017 593544102 2018-07-11 BONITA COMMUNITY HEALTH CENTER, INC 63
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2018-07-11
Name of individual signing SARA M MCCALLUM
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2016 593544102 2017-06-20 BONITA COMMUNITY HEALTH CENTER, INC. 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2017-06-20
Name of individual signing SARA MCCALLUM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-20
Name of individual signing SARA MCCALLUM
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2015 593544102 2016-07-20 BONITA COMMUNITY HEALTH CENTER, INC. 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2016-07-20
Name of individual signing SARA MCCALLUM
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2014 593544102 2015-07-23 BONITA COMMUNITY HEALTH CENTER, INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399496115
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing SARA MCCALLUM
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2013 593544102 2014-07-29 BONITA COMMUNITY HEALTH CENTER, INC. 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2014-07-29
Name of individual signing LARISA ZADORECKY
Valid signature Filed with authorized/valid electronic signature
BONITA COMMUNITY HEALTH CENTER, INC. 401(K) PLAN 2012 593544102 2013-07-26 BONITA COMMUNITY HEALTH CENTER, INC. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-11-16
Business code 621498
Sponsor’s telephone number 2399491050
Plan sponsor’s address 3501 HEALTH CENTER BLVD., BONITA SPRINGS, FL, 34135

Signature of
Role Plan administrator
Date 2013-07-26
Name of individual signing LARISA ZADORECKY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-26
Name of individual signing LARISA ZADORECKY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MCGILLICUDDY, MARY A Agent 4211 METRO PARKWAY, LEGAL SERVICES, LEE HEALTH CORPORATE CENTER, FORT MYERS, FL 33916

CHAIR

Name Role
ROSE-ANNE, INC. CHAIR

VICE CHAIR

Name Role Address
BRADACH, SUZANNE VICE CHAIR OUTPATIENT CENTER AT THE SANCTUARY, 8960 COLONIAL CENTER DRIVE STE 208 FORT MYERS, FL 33905

Treasurer

Name Role Address
SPENCE, BEN Treasurer 16451 HEALTHPARK COMMONS DRIVE, STE 200 FORT MYERS, FL 33908

Secretary

Name Role Address
SPENCE, BEN Secretary 9800 S HEALTHPARK DRIVE, STE 350 FORT MYERS, FL 33908

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000027862 BONITA HEALTH CENTER ACTIVE 2020-03-04 2025-12-31 No data 3501 HEALTH CENTER BOULEVARD, BONITA SPRINGS, FL, 34135

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-10-30 3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135 No data
AMENDED AND RESTATEDARTICLES 2024-10-30 No data No data
REGISTERED AGENT NAME CHANGED 2021-04-14 MCGILLICUDDY, MARY A No data
REGISTERED AGENT ADDRESS CHANGED 2019-12-23 4211 METRO PARKWAY, LEGAL SERVICES, LEE HEALTH CORPORATE CENTER, FORT MYERS, FL 33916 No data
AMENDMENT 2019-12-23 No data No data
CHANGE OF MAILING ADDRESS 2019-12-23 3501 HEALTH CENTER BLVD, BONITA SPRINGS, FL 34135 No data
AMENDMENT 2011-03-04 No data No data
REINSTATEMENT 2002-11-06 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2002-10-04 No data No data
AMENDMENT 1999-07-21 No data No data

Documents

Name Date
Amended and Restated Articles 2024-10-30
ANNUAL REPORT 2024-03-12
ANNUAL REPORT 2023-04-06
ANNUAL REPORT 2022-04-08
ANNUAL REPORT 2021-04-14
ANNUAL REPORT 2020-03-11
Amendment 2019-12-23
AMENDED ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2019-02-20
ANNUAL REPORT 2018-01-26

Related by officers

MCGILLICUDDY, MARY A

CAPE MEMORIAL HOSPITAL, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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