| Entity Name: | CLINICARE CLINICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Dec 2009 (15 years ago) |
| Document Number: | P09000102197 |
| FEI/EIN Number | 20-3728794 |
| Address: | 2112 SUNNYDALE BLVD., STE B, CLEARWATER, FL 33765-1207 |
| Mail Address: | PO BOX 16264, CLEARWATER, FL 33766-6264 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609818145 | 2006-06-11 | 2021-09-05 | PO BOX 16264, CLEARWATER, FL, 337666264, US | 2112 SUNNYDALE BLVD STE B, CLEARWATER, FL, 337651207, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 727-796-2904 |
| Fax | 7277962965 |
| Fax | 8669615586 |
Authorized person
| Name | MS. KIMBERLY ANN JOHNS |
| Role | CEO |
| Phone | 7277962904 |
Taxonomy
| Taxonomy Code | 261QS1200X - Sleep Disorder Diagnostic Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA AHCA HEALTHCARE CLINIC LICENSE |
| Number | HCC8722 |
| State | FL |
| Issuer | FLORIDA BLUE CROSS |
| Number | 0010Y |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JOHNS, KIMBERLY A | Agent | 2112 SUNNYDALE BLVD., STE B, CLEARWATER, FL 33765-1207 |
| Name | Role | Address |
|---|---|---|
| JOHNS, KIMBERLY A | President | 2112 SUNNYDALE BLVD., STE B CLEARWATER, FL 33765-1207 |
| Name | Role | Address |
|---|---|---|
| JOHNS, KIMBERLY A | Director | 2112 SUNNYDALE BLVD., STE B CLEARWATER, FL 33765-1207 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000036143 | CLINICARE DIAGNOSTIC MEDICAL SERVICES | ACTIVE | 2016-04-08 | 2026-12-31 | No data | 2112 SUNNYDALE BLVD, STE B, CLEARWATER, FL, 33765 |
| G10000113620 | CLINICARE DIAGNOSTIC MEDICAL SERVICES | EXPIRED | 2010-12-13 | 2015-12-31 | No data | 2194 MAIN STREET, SUITE 1, DUNEDIN, FL, 34698 |
| G09000188214 | CLINICARE DIAGNOSTIC MEDICAL SERVICES | EXPIRED | 2009-12-23 | 2014-12-31 | No data | 2194 MAIN STREET, SUITE I, DUNEDIN, FL, 34698 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-02 | 2112 SUNNYDALE BLVD., STE B, CLEARWATER, FL 33765-1207 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-09 | 2112 SUNNYDALE BLVD., STE B, CLEARWATER, FL 33765-1207 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-09 | 2112 SUNNYDALE BLVD., STE B, CLEARWATER, FL 33765-1207 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-30 | JOHNS, KIMBERLY A | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-04-10 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-03-24 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-04-08 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
