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FLORIDA BLUE MEDICARE, INC. - Florida Company Profile

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Company Details

Entity Name: FLORIDA BLUE MEDICARE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 22 Jun 2018 (7 years ago)
Document Number: P18000055586
FEI/EIN Number 83-1056418
Address: 4800 DEERWOOD CAMPUS PKWY., JACKSONVILLE, FL, 32246, US
Mail Address: 4800 DEERWOOD CAMPUS PKWY., JACKSONVILLE, FL, 32246, US
ZIP code: 32246
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
HARRISON CAMILLE Chairman 4800 DEERWOOD CAMPUS PARKWAY DC 1-8, JACKSONVILLE, FL, 32246
Schrader Elana Dr. Director 4800 DEERWOOD CAMPUS PARKWAY 1-8, JACKSONVILLE, FL, 32246
Dorsett Kareen Treasurer 4800 DEERWOOD CAMPUS PARKWAY DC 4-3, JACKSONVILLE, FL, 32246
Jolly Arezou C Secretary 4800 DEERWOOD CAMPUS PARKWAY DC 1-7, JACKSONVILLE, FL, 32246
GODDARD JEFFREY Chief Financial Officer 4800 DEERWOOD CAMPUS PARKWAY DC 1-8, JACKSONVILLE, FL, 32246
MACCARTHY DEIRDRE Agent 4800 DEERWOOD CAMPUS PKWY DC 1-7, JACKSONVILLE, FL, 32246
Anderson Gary Director 4800 DEERWOOD CAMPUS PARKWAY 1-8, JACKSONVILLE, FL, 32246

National Provider Identifier

NPI Number:
1750074894
Certification Date:
2023-06-01

Authorized Person:

Name:
KAREEN DORSETT
Role:
VP MEDICARE CFO
Phone:

Taxonomy:

Selected Taxonomy:
302R00000X - Health Maintenance Organization
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000115566 FHCP MEDICARE ACTIVE 2019-10-25 2029-12-31 - 4800 DEERWOOD CAMPUS PARKWAY, JACKSONVILLE, FL, 32246
G19000113257 FLORIDA BLUE MEDICARE ACTIVE 2019-10-18 2029-12-31 - 4800 DEERWOOD CAMPUS PARKWAY, JACKSONVILLE, FL, 32246

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-04-23 4800 DEERWOOD CAMPUS PKWY DC 1-7, JACKSONVILLE, FL 32246 -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2024-04-17
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-04-20
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-04-13
ANNUAL REPORT 2019-04-18
Domestic Profit 2018-06-22

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Date of last update: 02 Jul 2025

Sources: Florida Department of State