| Entity Name: | FLORIDA MED CENTER OF CLEARWATER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Mar 1996 (29 years ago) |
| Document Number: | P96000027114 |
| FEI/EIN Number | 59-3381344 |
| Address: | 1840 N. HIGHLAND AVE., CLEARWATER, FL 33755 |
| Mail Address: | 1840 N. HIGHLAND AVE., CLEARWATER, FL 33755 |
| ZIP code: | 33755 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720075765 | 2005-10-04 | 2013-06-10 | 1840 N HIGHLAND AVE, CLEARWATER, FL, 337552138, US | 1840 N HIGHLAND AVE, CLEARWATER, FL, 337552138, US | |||||||||||||||||||||||||
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| Phone | +1 727-442-3001 |
| Fax | 7274679106 |
Authorized person
| Name | DR. ALI M SAIFI |
| Role | PRESIDENT |
| Phone | 7274423001 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005457500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SAIFI, ALI | Agent | 1840 N. HIGHLAND AVE, CLEARWATER, FL 33755 |
| Name | Role | Address |
|---|---|---|
| SAIFI, ALI | President | 1840 N HIGHLAND, CLEARWATER, FL 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2004-01-12 | 1840 N. HIGHLAND AVE., CLEARWATER, FL 33755 | No data |
| CHANGE OF MAILING ADDRESS | 2004-01-12 | 1840 N. HIGHLAND AVE., CLEARWATER, FL 33755 | No data |
| REGISTERED AGENT NAME CHANGED | 2004-01-12 | SAIFI, ALI | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-01-12 | 1840 N. HIGHLAND AVE, CLEARWATER, FL 33755 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-11 |
| ANNUAL REPORT | 2023-02-20 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-02-16 |
| ANNUAL REPORT | 2018-02-10 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
