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  5. OPTIMUM HEALTHCARE, INC.

OPTIMUM HEALTHCARE, INC.

Company Details

Entity Name: OPTIMUM HEALTHCARE, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 01 Jul 2004 (21 years ago)
Last Event: AMENDMENT
Event Date Filed: 17 Nov 2006 (18 years ago)
Document Number: P04000099338
FEI/EIN Number 20-1336412
Address: 5411 SkyCenter Drive, Tampa, FL 33607
Mail Address: 5411 SkyCenter Drive, Tampa, FL 33607
ZIP code: 33607
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1316318363 2015-10-16 2015-10-16 5403 N CHURCH AVE, TAMPA, FL, 336145611, US 5403 N CHURCH AVE, TAMPA, FL, 336145611, US

Contacts
Phone +1 813-506-6000
Fax 8885480091

Authorized person
Name DR. KIRAN PATEL
Role PRESIDENT
Phone 8135066000

Taxonomy
Taxonomy Code 302R00000X - Health Maintenance Organization
License Number 87098
State FL
Is Primary Yes

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
54930089FBKOCWDANP39 P04000099338 US-FL GENERAL ACTIVE 2004-07-01

Addresses
Legal C/O CT CORPORATION SYSTEM, 1200 S PINE ISLAND RD, PLANTATION, US-FL, US, 33324
Headquarters 9250 W. FLAGLER STREET, SUITE 600, MIAMI, US-FL, US, 33174

Registration details
Registration Date 2020-02-24
Last Update 2024-02-20
Status ISSUED
Next Renewal 2025-02-20
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As P04000099338

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OPTIMUM HEALTHCARE, INC. 401(K) PROFIT SHARING PLAN & TRUST 2014 201336412 2017-11-07 OPTIMUM HEALTHCARE, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8135066000
Plan sponsor’s address 5403 CHURCH AVE., TAMPA, FL, 33614

Signature of
Role Plan administrator
Date 2017-11-07
Name of individual signing MEGAN LEVIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-11-07
Name of individual signing MEGAN LEVIN
Valid signature Filed with authorized/valid electronic signature
OPTIMUM HEALTHCARE INC 401 K PROFIT SHARING PLAN TRUST 2010 201336412 2011-06-01 OPTIMUM HEALTHCARE INC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8135066102
Plan sponsor’s address 5403 N CHURCH AVE, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 201336412
Plan administrator’s name OPTIMUM HEALTHCARE INC
Plan administrator’s address 5403 N CHURCH AVE, TAMPA, FL, 33614
Administrator’s telephone number 8135066102

Signature of
Role Plan administrator
Date 2011-06-01
Name of individual signing OPTIMUM HEALTHCARE INC
Valid signature Filed with authorized/valid electronic signature
OPTIMUM HEALTHCARE INC 2009 201336412 2010-07-15 OPTIMUM HEALTHCARE INC 3
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8135066102
Plan sponsor’s address PO BOX 152697, TAMPA, FL, 33684

Plan administrator’s name and address
Administrator’s EIN 201336412
Plan administrator’s name OPTIMUM HEALTHCARE INC
Plan administrator’s address PO BOX 152697, TAMPA, FL, 33684
Administrator’s telephone number 8135066102

Signature of
Role Plan administrator
Date 2010-07-15
Name of individual signing OPTIMUM HEALTHCARE INC
Valid signature Filed with incorrect/unrecognized electronic signature
OPTIMUM HEALTHCARE INC 2009 201336412 2010-07-23 OPTIMUM HEALTHCARE INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8135066102
Plan sponsor’s address PO BOX 152697, TAMPA, FL, 33684

Plan administrator’s name and address
Administrator’s EIN 201336412
Plan administrator’s name OPTIMUM HEALTHCARE INC
Plan administrator’s address PO BOX 152697, TAMPA, FL, 33684
Administrator’s telephone number 8135066102

Signature of
Role Plan administrator
Date 2010-07-23
Name of individual signing OPTIMUM HEALTHCARE INC
Valid signature Filed with authorized/valid electronic signature
OPTIMUM HEALTHCARE INC 2009 201336412 2010-06-28 OPTIMUM HEALTHCARE INC 0
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8135066102
Plan sponsor’s address PO BOX 152697, TAMPA, FL, 33684

Plan administrator’s name and address
Administrator’s EIN 201336412
Plan administrator’s name OPTIMUM HEALTHCARE INC
Plan administrator’s address PO BOX 152697, TAMPA, FL, 33684
Administrator’s telephone number 8135066102

Signature of
Role Plan administrator
Date 2010-06-28
Name of individual signing OPTIMUM HEALTHCARE INC
Valid signature Filed with incorrect/unrecognized electronic signature
OPTIMUM HEALTHCARE INC 2009 201336412 2010-06-29 OPTIMUM HEALTHCARE INC 3
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8135066102
Plan sponsor’s address PO BOX 152697, TAMPA, FL, 33684

Plan administrator’s name and address
Administrator’s EIN 201336412
Plan administrator’s name OPTIMUM HEALTHCARE INC
Plan administrator’s address PO BOX 152697, TAMPA, FL, 33684
Administrator’s telephone number 8135066102

Signature of
Role Plan administrator
Date 2010-06-29
Name of individual signing OPTIMUM HEALTHCARE INC
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
CT CORPORATION SYSTEM Agent 1200 S PINE ISLAND RD, PLANTATION, FL 33324

Assistant Treasurer

Name Role Address
Noble, Eric Kenneth Assistant Treasurer 5411 SkyCenter Drive, Tampa, FL 33607

Authority to Sign

Name Role Address
Caruso, David Authority to Sign 5411 SkyCenter Drive, Tampa, FL 33607
Goluch, Adrian Authority to Sign 5411 SkyCenter Drive, Tampa, FL 33607
Hacek, Ken Authority to Sign 5411 SkyCenter Drive, Tampa, FL 33607
Molina, Michelle Authority to Sign 5411 SkyCenter Drive, Tampa, FL 33607
Myers, Lisa Authority to Sign 5411 SkyCenter Drive, Tampa, FL 33607

President

Name Role Address
Newman, Elena Paul President 5411 SkyCenter Drive, Tampa, FL 33607

Chief Executive Officer

Name Role Address
Newman, Elena Paul Chief Executive Officer 5411 SkyCenter Drive, Tampa, FL 33607

Director

Name Role Address
Newman, Elena Paul Director 5411 SkyCenter Drive, Tampa, FL 33607
Dewane, Jennifer Ann Director 5411 SkyCenter Drive, Tampa, FL 33607
Penczek, Ronald William Director 5411 SkyCenter Drive, Tampa, FL 33607
Turano, Michelle Giovanni Director 5411 SkyCenter Drive, Tampa, FL 33607

Valuation Actuary

Name Role Address
Ellis, Claudia Valuation Actuary 5411 SkyCenter Drive, Tampa, FL 33607

Secretary

Name Role Address
Kiefer, Kathleen Susan Secretary 5411 SkyCenter Drive, Tampa, FL 33607

Vice President

Name Role Address
Kiefer, Kathleen Susan Vice President 5411 SkyCenter Drive, Tampa, FL 33607

Treasurer

Name Role Address
Scher, Vincent Edward Treasurer 5411 SkyCenter Drive, Tampa, FL 33607

Chief Medical Director

Name Role Address
Stern, Mark Sam Chief Medical Director 5411 SkyCenter Drive, Tampa, FL 33607

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-15 5411 SkyCenter Drive, Tampa, FL 33607 No data
CHANGE OF MAILING ADDRESS 2024-03-15 5411 SkyCenter Drive, Tampa, FL 33607 No data
REGISTERED AGENT ADDRESS CHANGED 2018-08-08 1200 S PINE ISLAND RD, PLANTATION, FL 33324 No data
REGISTERED AGENT NAME CHANGED 2018-08-08 CT CORPORATION SYSTEM No data
AMENDMENT 2006-11-17 No data No data
AMENDMENT 2006-06-20 No data No data
AMENDMENT 2006-02-06 No data No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J22000000275 ACTIVE 21002487SCAXMX FL 5TH CIRCUIT - COUNTY COURT 2021-12-14 2027-01-03 $10,957.90 CHAPEL PODIATRY & ASSOCIATES, P.A., 12084 CORTEZ BLVD, BROOKSVILLE, FL 34613

Documents

Name Date
ANNUAL REPORT 2024-03-15
ANNUAL REPORT 2023-02-24
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-04-05
ANNUAL REPORT 2020-06-22
ANNUAL REPORT 2019-03-14
AMENDED ANNUAL REPORT 2018-08-15
Reg. Agent Change 2018-08-08
ANNUAL REPORT 2018-04-27
ANNUAL REPORT 2017-03-14

Related by officers

Noble, Eric Kenneth

SIMPLY HEALTHCARE PLANS, INC. LIVING COMPLETE TECHNOLOGIES, INC. CARELON HEALTH SOLUTIONS, INC. CARELON HEALTH FEDERAL SERVICES, INC. CARELON POST ACUTE SOLUTIONS, INC. CARELON BEHAVIORAL HEALTH OF CALIFORNIA, INC. CARELONRX, INC. CARELON INSIGHTS, INC. CARELON BEHAVIORAL CARE, INC. CARELON DIGITAL PLATFORMS, INC.

Caruso, David

OCEAN WINDOW CLEANING, LLC FREEDOM HEALTH, INC.

Goluch, Adrian

FREEDOM HEALTH, INC.

Hacek, Ken

FREEDOM HEALTH, INC.

Molina, Michelle

M3 CONSTRUCTION GROUP LLC FREEDOM HEALTH, INC.

Myers, Lisa

FREEDOM HEALTH, INC.

Newman, Elena Paul

HEALTHSUN HEALTH PLANS, INC. FREEDOM HEALTH, INC.

Dewane, Jennifer Ann

SIMPLY HEALTHCARE PLANS, INC. HIGHLAND INTERMEDIATE HOLDINGS, LLC HIGHLAND INVESTOR HOLDINGS, LLC HIGHLAND ACQUISITION HOLDINGS, LLC HEALTHSUN HEALTH PLANS, INC. FREEDOM HEALTH, INC.

Ellis, Claudia

FREEDOM HEALTH, INC.

Penczek, Ronald William

SIMPLY HEALTHCARE PLANS, INC. LIVING COMPLETE TECHNOLOGIES, INC. CARELON HEALTH SOLUTIONS, INC. CARELON HEALTH FEDERAL SERVICES, INC. CARELON POST ACUTE SOLUTIONS, INC. HIGHLAND INTERMEDIATE HOLDINGS, LLC HIGHLAND INVESTOR HOLDINGS, LLC HIGHLAND ACQUISITION HOLDINGS, LLC CARELON BEHAVIORAL CARE, INC. ELEVANCE HEALTH, INC.

Kiefer, Kathleen Susan

PASTEUR MEDICAL BIRD ROAD, LLC PASTEUR MEDICAL NORTH MIAMI BEACH, LLC EASYSCRIPTS CUTLER BAY, LLC PASTEUR MEDICAL MANAGEMENT, LLC SIMPLY HEALTHCARE PLANS, INC. LIVING COMPLETE TECHNOLOGIES, INC. PASTEUR MEDICAL CUTLER BAY, LLC WELLPOINT PARTNERSHIP PLAN, LLC PASTEUR MEDICAL HIALEAH GARDENS, LLC EASYSCRIPTS WESTCHESTER, LLC.

Scher, Vincent Edward

SIMPLY HEALTHCARE PLANS, INC. LIVING COMPLETE TECHNOLOGIES, INC. CARELON HEALTH SOLUTIONS, INC. CARELON HEALTH FEDERAL SERVICES, INC. CARELON POST ACUTE SOLUTIONS, INC. CARELON BEHAVIORAL HEALTH OF CALIFORNIA, INC. HIGHLAND INTERMEDIATE HOLDINGS, LLC HIGHLAND INVESTOR HOLDINGS, LLC HIGHLAND ACQUISITION HOLDINGS, LLC CARELONRX, INC.

Turano, Michelle Giovanni

FREEDOM HEALTH, INC.

Stern, Mark Sam

MARK STERN, M.D. CONSULTING L.L.C. FREEDOM HEALTH, INC.

CT CORPORATION SYSTEM

TMB PANAMA, LLC NAPLES FLORIDA II, LIMITED PARTNERSHIP EXTRA SPACE OF COCONUT POINT LLC MORAN SHIPPING AGENCIES INC. CS KEY WEST I, LLC. MARINA MANAGER, INC. DALLAS NATIONAL INSURANCE COMPANY MAYARAINBOW II, LLC PRESTON STABLES, LLC NW FLORIDA EMERGENCY PHYSICIANS, LLC

Related by address

5411 SkyCenter Drive, Tampa, FL 33607

FREEDOM HEALTH, INC.

5411 SkyCenter Drive, Tampa, FL 33607

FREEDOM HEALTH, INC.

Date of last update: 05 Jan 2025

Sources: Florida Department of State

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