WELLCARE HEALTH INSURANCE OF ARIZONA, INC.

Company Details

Entity Name:	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.
Jurisdiction:	FLORIDA
Filing Type:	Foreign Profit
Status:	Active
Date Filed:	21 Oct 1987 (37 years ago)
Document Number:	P16463
FEI/EIN Number	860269558
Mail Address:	7700 Forsyth Blvd, St. Louis, MO, 63105, US
Address:	1850 W Rio Salado Pkwy, Tempe, AZ, 85281, US
Place of Formation:	ARIZONA

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1952625204

2010-03-16

2016-05-05

8735 HENDERSON RD, TAMPA, FL, 336341143, US

8735 HENDERSON RD, TAMPA, FL, 336341143, US

Contacts

Phone

+1 813-290-6200

Authorized person

Name	MICHAEL HABER
Role	VP & SECRETARY
Phone	8132061490

Taxonomy

Taxonomy Code	302R00000X - Health Maintenance Organization
Is Primary	Yes

Agent

Name	Role
C T CORPORATION SYSTEM	Agent

President

Name	Role	Address
Sivik Scott J	President	949 KAMOKILA BOULEVARD, KAPOLEI, HI, 96707

Vice President

Name	Role	Address
Dinkelman Tricia	Vice President	7700 Forsyth Blvd, St. Louis, MO, 63105

Chief Financial Officer

Name	Role	Address
Roberts Glenn	Chief Financial Officer	8735 Henderson Road, Tampa, FL, 33634

Director

Name	Role	Address
Burns Eric	Director	8735 Henderson Road, Tampa, FL, 33634
Lee Andy	Director	8735 Henderson Road, Tampa, FL, 33634
Shintaku Kari J	Director	949 Kamokila Blvd, Kapolei, HI, 96707

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G21000077358	WELLCARE	ACTIVE	2021-06-09	2026-12-31	No data	8735 HENDERSON ROAD, TAMPA, FL, 33634

Events

Event Type	Filed Date	Value	Description
NAME CHANGE AMENDMENT	2006-08-14	WELLCARE HEALTH INSURANCE OF ARIZONA, INC.	No data
DROPPING DBA	1999-11-15	ADVANCE INSURANCE COMPANY	No data
NAME CHANGE AMENDMENT	1994-11-10	ADVANCE INSURANCE COMPANY OF AMERICA	No data

Date of last update: 01 Jan 2025

Sources: Florida Department of State