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FLAMINGO PARK KIDNEY CENTER, INC. - Florida Company Profile

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Company Details

Entity Name: FLAMINGO PARK KIDNEY CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 28 May 1993 (32 years ago)
Last Event: CORPORATE MERGER
Event Date Filed: 31 Dec 1996 (29 years ago)
Document Number: P93000038433
FEI/EIN Number 650431823
Address: 2000 16th Street, JLD/SecGovFin, Denver, CO, 80202, US
Mail Address: 601 Hawaii Street, JLD/SecGovFin, El Segundo, CA, 90245, US
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Caldwell Samantha A Auth 2000 16th Street, Denver, CO, 80202
Berry Christopher M Treasurer 2000 16th Street, Denver, CO, 80202
Berberich Stephanie N Secretary 2000 16th Street, Denver, CO, 80202
Maughan David P Director 2000 16th Street, Denver, CO, 80202
- Agent -

Unique Entity ID

Unique Entity ID:
NV6ULAKU6FQ1
CAGE Code:
5WTJ1
UEI Expiration Date:
2026-05-14

Business Information

Doing Business As:
INTERAMERICAN DIALYSIS
Activation Date:
2025-05-20
Initial Registration Date:
2010-02-25

Commercial and government entity program

CAGE number:
5WTJ9
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2023-02-03
CAGE Expiration:
2027-01-06
SAM Expiration:
2023-02-03

Contact Information

POC:
DONNA BRAWLEY

Immediate Level Owner

Vendor Certified:
2022-01-06
CAGE number:
45JM2
Company Name:
DAVITA INC.

National Provider Identifier

NPI Number:
1780651802
Certification Date:
2025-03-20

Authorized Person:

Name:
SAMUEL T WEY
Role:
VP, LICENSURE & CERTIFICATION
Phone:

Taxonomy:

Selected Taxonomy:
261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3054454984

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000105932 CORAL GABLES KIDNEY CENTER ACTIVE 2015-10-16 2025-12-31 - 601 HAWAII STREET, EL SEGUNDO, CA, 90245
G15000100829 FLAMINGO PARK KIDNEY CENTER EXPIRED 2015-10-01 2020-12-31 - 601 HAWAII STREET, EL SEGUNDO, CA, 90245
G15000100887 INTERAMERICAN DIALYSIS CENTER ACTIVE 2015-10-01 2025-12-31 - JLD/SECGOVFIN, 601 HAWAII STREET, EL SEGUNDO, CA, 90245
G09000121478 INTERAMERICAN DIALYSIS CENTER EXPIRED 2009-06-12 2014-12-31 - 7815 CORAL WAY, SUITE 115, MIAMI, FL, 33155
G09000100564 CORAL GABLES KIDNEY CENTER EXPIRED 2009-04-23 2014-12-31 - 3280 PONCE DE LEON BLVD., CORAL GABLES, FL, 33134

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-19 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 -
CHANGE OF MAILING ADDRESS 2024-04-19 2000 16th Street, JLD/SecGovFin, Denver, CO 80202 -
REGISTERED AGENT NAME CHANGED 2005-08-22 CORPORATION SERVICE COMPANY -
REGISTERED AGENT ADDRESS CHANGED 2005-08-22 1201 HAYS STREET, TALLAHASSEE, FL 32301-2525 -
CORPORATE MERGER 1996-12-31 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. CORPORATE MERGER NUMBER 100000012231

Documents

Name Date
ANNUAL REPORT 2024-04-19
ANNUAL REPORT 2023-04-14
ANNUAL REPORT 2022-04-23
ANNUAL REPORT 2021-04-20
ANNUAL REPORT 2020-04-20
ANNUAL REPORT 2019-04-15
ANNUAL REPORT 2018-04-16
ANNUAL REPORT 2017-04-19
ANNUAL REPORT 2016-04-20
ANNUAL REPORT 2015-04-28

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Date of last update: 02 Aug 2025

Sources: Florida Department of State