| Entity Name: | FAMILY WELLCARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Jun 2002 (23 years ago) |
| Document Number: | P02000060800 |
| FEI/EIN Number | 020616363 |
| Address: | 3935 Tampa Road, Suite 6, Oldsmar, FL, 34677, US |
| Mail Address: | 3935 Tampa Road, Suite 6, Oldsmar, FL, 34677, US |
| ZIP code: | 34677 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811082407 | 2006-10-03 | 2020-08-22 | 1700 MCMULLEN BOOTH ROAD, SUITE C-3, CLEARWATER, FL, 33759, US | 1700 MCMULLEN BOOTH ROAD, SUITE C-3, CLEARWATER, FL, 33759, US | |||||||||||||||||||||||||
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| Phone | +1 727-723-3921 |
| Fax | 7277231562 |
Authorized person
| Name | DR. WILLIAM ALVAREZ |
| Role | PRESIDENT |
| Phone | 7277233921 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS0006142 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UHC |
| Number | 2217391 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FAMILY WELLCARE PA 401 K PROFIT SHARING PLAN TRUST | 2010 | 020616363 | 2011-06-30 | FAMILY WELLCARE, P.A. | 5 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 020616363 |
| Plan administrator’s name | FAMILY WELLCARE, P.A. |
| Plan administrator’s address | 1700 N MCMULLEN BOOTH RD #C-3, CLEARWATER, FL, 33759 |
| Administrator’s telephone number | 7277233921 |
Signature of
| Role | Plan administrator |
| Date | 2011-06-30 |
| Name of individual signing | FAMILY WELLCARE, P.A. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7277233921 |
| Plan sponsor’s address | 1700 N MCMULLEN BOOTH RD STE C, CLEARWATER, FL, 33759 |
Plan administrator’s name and address
| Administrator’s EIN | 020616363 |
| Plan administrator’s name | FAMILY WELLCARE, P.A. |
| Plan administrator’s address | 1700 N MCMULLEN BOOTH RD STE C, CLEARWATER, FL, 33759 |
| Administrator’s telephone number | 7277233921 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-07 |
| Name of individual signing | FAMILY WELLCARE, P.A. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Paolucci Nancy | Agent | 70 Kelleys Trail, Oldsmar, FL, 34677 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ WILLIAM | President | 3935 Tampa Road, Oldsmar, FL, 34677 |
| Name | Role | Address |
|---|---|---|
| ALVAREZ WILLIAM | Chief Executive Officer | 3935 Tampa Road, Oldsmar, FL, 34677 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
