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  5. CLEARWATER NATURAL MEDICAL CENTER, INC.

CLEARWATER NATURAL MEDICAL CENTER, INC.

Company Details

Entity Name: CLEARWATER NATURAL MEDICAL CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 01 Mar 1996 (29 years ago)
Document Number: P96000019264
FEI/EIN Number 593363851
Address: 2038 Otter Way, Palm Harbor, FL, 34685, US
Mail Address: 2038 Otter Way, Palm Harbor, FL, 34685, US
ZIP code: 34685
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1942334248 2007-03-16 2020-08-22 2454 N MCMULLEN BOOTH RD STE 609, CLEARWATER, FL, 337591337, US 2454 N MCMULLEN BOOTH RD STE 609, CLEARWATER, FL, 337591337, US

Contacts
Phone +1 727-726-7333

Authorized person
Name DR. JOHN O NEILL
Role OWNER OPERATOR
Phone 7277267333

Taxonomy
Taxonomy Code 171100000X - Acupuncturist
License Number AP0000269
State FL
Is Primary No
Taxonomy Code 171100000X - Acupuncturist
License Number AP1655
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS
Number B0093
State FL
Issuer BLUE CROSS
Number B0862
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLEARWATER NATURAL MEDICAL CENTER, INC DEFINED BENEFIT PENSON PLAN AND /TRUST 2014 593363851 2015-08-27 CLEARWATER NATURAL MEDICAL CENTER, INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 7277267333
Plan sponsor’s address 2038 OTTER WAY, PALM HARBOR, FL, 34685

Signature of
Role Plan administrator
Date 2015-08-27
Name of individual signing JOHN O'NEILL
Valid signature Filed with authorized/valid electronic signature
CLEARWATER NATURAL MEDICAL CENTER, INC DEFINED BENEFIT PENSON PLAN AND /TRUST 2013 593363851 2014-10-07 CLEARWATER NATURAL MEDICAL CENTER, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 7277267333
Plan sponsor’s address 2038 OTTER WAY, PALM HARBOR, FL, 34685

Signature of
Role Plan administrator
Date 2014-10-07
Name of individual signing JOHN O'NEILL
Valid signature Filed with authorized/valid electronic signature
CLEARWATER NATURAL MEDICAL CENTER, INC. DEFINED BENEFIT PENSION PLAN AND TRUST 2012 593363851 2013-10-10 CLEARWATER NATURAL MEDICAL CENTER, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 7277267333
Plan sponsor’s address 2454 MCMULLEN BOOTH ROAD, SUITE 609, CLEARWATER, FL, 337591337

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing JOHN O'NEILL
Valid signature Filed with authorized/valid electronic signature
CLEARWATER NATURAL MEDICAL CENTER, INC. DEFINED BENEFIT PENSION PLAN AND TRUST 2011 593363851 2012-10-15 CLEARWATER NATURAL MEDICAL CENTER, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 7277267333
Plan sponsor’s address 2454 MCMULLEN BOOTH ROAD, SUITE 609, CLEARWATER, FL, 337591337

Plan administrator’s name and address
Administrator’s EIN 593363851
Plan administrator’s name CLEARWATER NATURAL MEDICAL CENTER, INC.
Plan administrator’s address 2454 MCMULLEN BOOTH ROAD, SUITE 609, CLEARWATER, FL, 337591337
Administrator’s telephone number 7277267333

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing MENDY MCKENDRY
Valid signature Filed with authorized/valid electronic signature
CLEARWATER NATURAL MEDICAL CENTER, INC. DEFINED BENEFIT PENSION PLAN AND TRUST 2010 593363851 2011-10-13 CLEARWATER NATURAL MEDICAL CENTER, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 7277267333
Plan sponsor’s mailing address 2454 MCMULLEN BOOTH ROAD, SUITE 609, CLEARWATER, FL, 337591337
Plan sponsor’s address SUITE 609, CLEARWATER, FL, 33759

Plan administrator’s name and address
Administrator’s EIN 593363851
Plan administrator’s name CLEARWATER NATURAL MEDICAL CENTER, INC.
Plan administrator’s address 2454 MCMULLEN BOOTH ROAD, SUITE 609, CLEARWATER, FL, 337591337
Administrator’s telephone number 7277267333

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing MENDY MCKENDRY
Valid signature Filed with authorized/valid electronic signature
CLEARWATER NATURAL MEDICAL CENTER, INC. DEFINED DEFINED PENSION PLAN AND TRUST 2009 593363851 2010-10-15 CLEARWATER NATURAL MEDICAL CENTER, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621399
Sponsor’s telephone number 7277267333
Plan sponsor’s mailing address 2454 MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33759
Plan sponsor’s address SUITE 609, CLEARWATER, FL, 33759

Plan administrator’s name and address
Administrator’s EIN 593363851
Plan administrator’s name CLEARWATER NATURAL MEDICAL CENTER, INC.
Plan administrator’s address 2454 MCMULLEN BOOTH ROAD, CLEARWATER, FL, 33759
Administrator’s telephone number 7277267333

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing MENDY MCKENDRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
O'NEILL JOHN Agent 2038 OTTER WAY, PALM HARBOR, FL, 34685

Chief Executive Officer

Name Role Address
O'NEILL JOHN Chief Executive Officer 2038 OTTER WAY, PALM HARBOR, FL, 34685

Events

Event Type Filed Date Value Description
CANCEL ADM DISS/REV 2009-09-18 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2007-09-14 No data No data
NAME CHANGE AMENDMENT 1997-01-21 CLEARWATER NATURAL MEDICAL CENTER, INC. No data
NAME CHANGE AMENDMENT 1996-12-09 NORTHWOOD NATURAL MEDICAL CENTER, INC. No data

Related by officers

O'NEILL JOHN

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Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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