| Entity Name: | THE CLARK CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Oct 2002 (22 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 11 Jan 2023 (2 years ago) |
| Document Number: | P02000108873 |
| FEI/EIN Number | 542078370 |
| Address: | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513, US |
| Mail Address: | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513, US |
| ZIP code: | 33513 |
| County: | Sumter |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134873011 | 2022-02-09 | 2022-02-09 | 212 S FLA ST, BUSHNELL, FL, 335136703, US | 10840 N US HIGHWAY 301, OXFORD, FL, 344843558, US | |||||||||||||||
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| Phone | +1 352-793-2441 |
| Phone | +1 352-787-1600 |
Authorized person
| Name | LOWELL F. CLARK |
| Role | MEDICAL DIRECTOR |
| Phone | 3527932441 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLARK LOWELL FMD | Agent | 212 SOUTH FLORIDA STREET, BUSHNELL,, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| CLARK LOWELL FMD | President | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| CLARK LOWELL FMD | Director | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| CLARK LOWELL FMD | Treasurer | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513 |
| Name | Role | Address |
|---|---|---|
| CLARK ELIZABETH E | Vice President | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000004195 | CLARK HEALTH | EXPIRED | 2019-01-09 | 2024-12-31 | No data | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513 |
| G08009700017 | CLARK CLINIC, INC. | EXPIRED | 2008-01-09 | 2013-12-31 | No data | 212 SOUTH FLORIDA STREET, BUSHNELL, FL, 33513 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-01-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-18 | CLARK, LOWELL F, MD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-23 |
| Amendment | 2023-01-11 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-16 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-02-11 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-02-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
