DAVITA MEDICAL FLORIDA, INC.

Company Details

Entity Name:	DAVITA MEDICAL FLORIDA, INC.
Jurisdiction:	FLORIDA
Filing Type:	Foreign Profit Corporation
Status:	Inactive
Date Filed:	01 Dec 1986 (38 years ago)
Date of dissolution:	09 Aug 2019 (6 years ago)
Last Event:	WITHDRAWAL
Event Date Filed:	09 Aug 2019 (6 years ago)
Document Number:	P12317
FEI/EIN Number	87-0408859
Address:	JLD/SecGovFin, 2000 16th Street, Denver, CO 80202
Mail Address:	1100 OPTUM CIRCLE, EDEN PRAIRIE, MN 55344
Place of Formation:	DELAWARE

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1508233537

2015-08-25

2017-07-21

10051 5TH STREET N., ST. PETERSBURG, FL, 33702, US

2424 MANATEE AVE W, SUITE 100, BRADENTON, FL, 342054954, US

Contacts

Phone

+1 941-847-7920

Authorized person

Name	LAUREN EDGINGTON
Role	CFO
Phone	7272864065

Taxonomy

Taxonomy Code	332900000X - Non-Pharmacy Dispensing Site
License Number	ME116650
State	FL
Is Primary	Yes

President

Name	Role	Address
Virnich, M.D., Daniel	President	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Chief Operating Officer

Name	Role	Address
Simpson, Tesha	Chief Operating Officer	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Chief Medical Officer

Name	Role	Address
Allen, M.D., Barbara L.	Chief Medical Officer	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Chief Financial Officer

Name	Role
GREEN JAY, LLC	Chief Financial Officer

Secretary

Name	Role	Address
Caldwell, Samantha A	Secretary	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Group Vice President

Name	Role	Address
Mehta, Chetan P.	Group Vice President	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Chief Accounting Officer

Name	Role	Address
Hilger, James K.	Chief Accounting Officer	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Chief Executive Officer

Name	Role	Address
Mello, Joseph C.	Chief Executive Officer	JLD/SecGovFin, 601 Hawaii Street EL SEGUNDO, CA 90245

Director

Name	Role	Address
Mello, Joseph C.	Director	JLD/SecGovFin, 601 Hawaii Street EL SEGUNDO, CA 90245

Treasurer

Name	Role	Address
Kotte, Vijay	Treasurer	JLD/SecGovFin, 2000 16th Street Denver, CO 80202

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G19000007525	JSA BEST GROUP	EXPIRED	2019-01-15	2024-12-31	No data	601 HAWAII STREET, EL SEGUNDO, CA, 90245
G18000101658	DAVITA MEDICAL GROUP-NORTH WESTMONTE	EXPIRED	2018-09-14	2023-12-31	No data	220 N. WESTMONTE DR, SUITE B, ALTAMONTE SPRINGS, FL, 32714
G18000023479	AMERIDRUG	EXPIRED	2018-02-14	2023-12-31	No data	601 HAWAII STREET, EL SEGUNDO, CA, 90245
G18000023486	AMERIDRUG PHARMACY	EXPIRED	2018-02-14	2023-12-31	No data	601 HAWAII STREET, ATTN: JLD/SECGOVFIN., EL SEGUNDO, CA, 90245
G17000037360	DAVITA MEDICAL GROUP, PHARMACY	EXPIRED	2017-04-07	2022-12-31	No data	10051 5TH ST. N., STE. 200, ST. PETERSBURG, FL, 33702
G17000015572	DAVITA PHARMACY	EXPIRED	2017-02-10	2022-12-31	No data	2000 16TH STREET, ATTN: JLD/SECGOVFIN., DENVER, CO, 80202
G17000015540	DAVITA MEDICAL GROUP FLORIDA	EXPIRED	2017-02-10	2022-12-31	No data	2000 16TH STREET, ATTN: JLD/SECGOVFIN., DENVER, CO, 80202
G17000015541	DAVITA MEDICAL GROUP	EXPIRED	2017-02-10	2022-12-31	No data	2000 16TH STREET, ATTN: JLD/SECGOVFIN., DENVER, CO, 80202
G17000015543	DAVITA MEDICAL FLORIDA	EXPIRED	2017-02-10	2022-12-31	No data	2000 16TH STREET, ATTN: JLD/SECGOVFIN., DENVER, CO, 80202
G17000015545	DAVITA PHARMACY FLORIDA	EXPIRED	2017-02-10	2022-12-31	No data	2000 16TH STREET, ATTN: JLD/SECGOVFIN., DENVER, CO, 80202
G17000009271	DAVITA MEDICAL GROUP	EXPIRED	2017-01-25	2022-12-31	No data	10051 5TH ST. N., STE. 200, ST. PETERSBURG, FL, 66702
G17000004457	JSA HEALTHCARE CORPORATION	EXPIRED	2017-01-12	2022-12-31	No data	10051 5TH ST. N., SUITE 200, ST. PETERSBURG, FL, 33702
G14000010468	NORTHSIDE FAMILY PRACTICE	EXPIRED	2014-01-30	2019-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000128490	TUSCAWILLA FAMILY MEDICINE	EXPIRED	2013-12-30	2018-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000128483	APOPKA FAMILY MEDICINE	EXPIRED	2013-12-30	2018-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000128487	ASSOCIATED FAMILY MEDICINE SABAL PALM	EXPIRED	2013-12-30	2018-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000128485	LAKE MARY FAMILY MEDICIN	EXPIRED	2013-12-30	2018-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000128494	NORTHSIDE FAMILY MEDICINE	EXPIRED	2013-12-30	2018-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000128489	SOUTH SEMINOLE FAMILY MEDICINE	EXPIRED	2013-12-30	2018-12-31	No data	10051 5TH STREET NORTH, ST. PETERSBURG, FL, 33702
G13000125209	JSA MEDICAL GROUP BAYWAY	EXPIRED	2013-12-20	2018-12-31	No data	10051 5TH ST., N., ST. PETERSBURG, FL, 33702

Events

Event Type	Filed Date	Value	Description
WITHDRAWAL	2019-08-09	No data	No data
CHANGE OF MAILING ADDRESS	2019-08-09	JLD/SecGovFin, 2000 16th Street, Denver, CO 80202	No data
REGISTERED AGENT CHANGED	2019-08-09	REGISTERED AGENT REVOKED	No data
CHANGE OF PRINCIPAL ADDRESS	2018-03-26	JLD/SecGovFin, 2000 16th Street, Denver, CO 80202	No data
NAME CHANGE AMENDMENT	2017-01-06	DAVITA MEDICAL FLORIDA, INC.	No data
NAME CHANGE AMENDMENT	1990-08-23	JSA HEALTHCARE CORPORATION	No data

Documents

Name	Date
Withdrawal	2019-08-09
ANNUAL REPORT	2019-04-29
ANNUAL REPORT	2018-03-26
ANNUAL REPORT	2017-04-19
Name Change	2017-01-06
ANNUAL REPORT	2016-04-27
ANNUAL REPORT	2015-04-28
ANNUAL REPORT	2014-04-26
ANNUAL REPORT	2013-04-22
ANNUAL REPORT	2012-04-06
ANNUAL REPORT	2011-01-07
ADDRESS CHANGE	2010-05-27
ANNUAL REPORT	2010-01-26
ANNUAL REPORT	2009-02-24
Reg. Agent Change	2008-02-08
ANNUAL REPORT	2008-01-29
ANNUAL REPORT	2007-04-09
ANNUAL REPORT	2006-07-07
ANNUAL REPORT	2005-01-10
ANNUAL REPORT	2004-01-20

Date of last update: 04 Feb 2025

Sources: Florida Department of State