| Entity Name: | DOCARE CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Nov 2004 (20 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P04000153235 |
| FEI/EIN Number | 201977541 |
| Address: | 3317 GANDY BLVD, TAMPA, FL, 33611, US |
| Mail Address: | P O BOX 172445, TAMPA, FL, 33672 |
| ZIP code: | 33611 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447433040 | 2007-12-06 | 2011-11-15 | PO BOX 172445, TAMPA, FL, 336720445, US | 3317 W GANDY BLVD, TAMPA, FL, 336112931, US | |||||||||||||||||||||||
|
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| Phone | +1 813-878-2222 |
Authorized person
| Name | CHUMA G OSUJI |
| Role | MEDICAL DIRECTOR |
| Phone | 8138782222 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | OS8399 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 272103100FL |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OSUJI CHUMA G | Agent | 3317 GANDY BLVD, TAMPA, FL, 33611 |
| Name | Role | Address |
|---|---|---|
| OSUJI CHUMA G | President | 3317 GANDY BLVD, TAMPA, FL, 33611 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000072500 | MERCY MEDICAL WELLNESS CENTER | EXPIRED | 2010-08-06 | 2015-12-31 | No data | P O BOX 172445, TAMPA, FL, 33672 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-02 | 3317 GANDY BLVD, TAMPA, FL 33611 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-02 | OSUJI, CHUMA G | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-02 | 3317 GANDY BLVD, TAMPA, FL 33611 | No data |
| AMENDMENT AND NAME CHANGE | 2007-06-01 | DOCARE CLINIC, INC. | No data |
| CHANGE OF MAILING ADDRESS | 2007-06-01 | 3317 GANDY BLVD, TAMPA, FL 33611 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-05-01 |
| ANNUAL REPORT | 2014-05-01 |
| ANNUAL REPORT | 2013-01-02 |
| ANNUAL REPORT | 2012-02-21 |
| ANNUAL REPORT | 2011-04-26 |
| ANNUAL REPORT | 2010-08-06 |
| ANNUAL REPORT | 2009-02-06 |
| ANNUAL REPORT | 2008-04-27 |
| Amendment and Name Change | 2007-06-01 |
| ANNUAL REPORT | 2007-04-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
