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  5. FLORIDA KIDNEY & HYPERTENSION CLINIC, INC.

FLORIDA KIDNEY & HYPERTENSION CLINIC, INC.

Company Details

Entity Name: FLORIDA KIDNEY & HYPERTENSION CLINIC, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 26 Feb 2008 (17 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 12 Oct 2019 (5 years ago)
Document Number: P08000021325
FEI/EIN Number 421758442
Address: 2140 KINGSLEY AVE, STE 10, ORANGE PARK, FL, 32073
Mail Address: 2140 KINGSLEY AVE, STE 10, ORANGE PARK, FL, 32073
ZIP code: 32073
County: Clay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982878450 2008-04-16 2010-06-10 2140 KINGSLEY AVE, SUITE 10, ORANGE PARK, FL, 320735180, US 2140 KINGSLEY AVE, SUITE 10, ORANGE PARK, FL, 320735129, US

Contacts
Phone +1 904-529-5252
Fax 9045295253

Authorized person
Name DR. RAMA THAMBUGANIPALLE
Role PRESIDENT
Phone 9044511005

Taxonomy
Taxonomy Code 207RN0300X - Nephrology Physician
License Number ME93749
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS
Number 54259
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 401(K) PLAN 2022 421758442 2023-10-11 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 401(K) PLAN 2021 421758442 2022-09-27 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2022-09-27
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. CASH BALANCE PENSION PLAN 2021 421758442 2022-10-19 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2022-10-19
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. CASH BALANCE PENSION PLAN 2021 421758442 2022-06-06 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 4
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2022-06-06
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. CASH BALANCE PENSION PLAN 2020 421758442 2021-10-05 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 401(K) PLAN 2020 421758442 2021-10-11 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. CASH BALANCE PENSION PLAN 2019 421758442 2020-10-15 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 401(K) PLAN 2019 421758442 2020-10-12 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2020-10-12
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. CASH BALANCE PENSION PLAN 2018 421758442 2019-10-14 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature
FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 401(K) PLAN 2018 421758442 2019-10-02 FLORIDA KIDNEY & HYPERTENSION CLINIC, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 9045295252
Plan sponsor’s address 2140 KINGLSEY AVENUE, SUITE 10, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing RAMA T. REDDY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Reddy Rama T Agent 2140 KINGSLEY AVE, ORANGE PARK, FL, 32073

Director

Name Role Address
REDDY RAMA T Director 2140 KINGSLEY AVE, STE 10, ORANGE PARK, FL, 32073
Kothapally Jagan M Director 2140 KINGSLEY AVE, ORANGE PARK, FL, 32073

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G08077900519 FLORIDA KIDNEY & HYPERTENSION CLINIC EXPIRED 2008-03-17 2013-12-31 No data 1820D COPPERSTONE DRIVE, ORANGE PARK, FL, 32003

Events

Event Type Filed Date Value Description
REINSTATEMENT 2019-10-12 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 No data No data
REGISTERED AGENT NAME CHANGED 2015-08-13 Reddy, Rama T. No data
CHANGE OF PRINCIPAL ADDRESS 2010-03-03 2140 KINGSLEY AVE, STE 10, ORANGE PARK, FL 32073 No data
CHANGE OF MAILING ADDRESS 2010-03-03 2140 KINGSLEY AVE, STE 10, ORANGE PARK, FL 32073 No data
REGISTERED AGENT ADDRESS CHANGED 2010-03-03 2140 KINGSLEY AVE, STE 10, ORANGE PARK, FL 32073 No data

Documents

Name Date
ANNUAL REPORT 2024-02-27
ANNUAL REPORT 2023-02-06
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-01-30
ANNUAL REPORT 2020-06-07
REINSTATEMENT 2019-10-12
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-03-20
ANNUAL REPORT 2016-03-21
AMENDED ANNUAL REPORT 2015-08-13

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2453997403 2020-05-05 0491 PPP 2140 KINGSLEY AVENUE SUITE 10, ORANGE PARK, FL, 32073
Loan Status Date 2021-11-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 95714
Loan Approval Amount (current) 95714
Undisbursed Amount 0
Franchise Name -
Lender Location ID 12096
Servicing Lender Name Wells Fargo Bank, National Association
Servicing Lender Address 101 N Philips Ave, SIOUX FALLS, SD, 57104-6738
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address ORANGE PARK, CLAY, FL, 32073-1600
Project Congressional District FL-04
Number of Employees 2
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 12096
Originating Lender Name Wells Fargo Bank, National Association
Originating Lender Address SIOUX FALLS, SD
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 97106.44
Forgiveness Paid Date 2021-10-20

Related by officers

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Related by address

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Date of last update: 02 Feb 2025

Sources: Florida Department of State

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