| Entity Name: | VALLACARE HEALTH SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Mar 1997 (28 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P97000020850 |
| FEI/EIN Number | 65-0752584 |
| Address: | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL 33950 |
| Mail Address: | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL 33950 |
| ZIP code: | 33950 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821085523 | 2005-09-29 | 2011-09-08 | 517 TAMIAMI TRL, SUITE A, PUNTA GORDA, FL, 339505520, US | 517 TAMIAMI TRL, SUITE A, PUNTA GORDA, FL, 339505520, US | |||||||||||||||
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| Phone | +1 941-575-1333 |
| Fax | 9415757755 |
Authorized person
| Name | BLANCA VALLADARES |
| Role | CEO |
| Phone | 9415751333 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 401(K) PROFIT SHARING PLAN & TRUST | 2011 | 650752584 | 2012-04-24 | VALLACARE HEALTH SERVICES INC | 2 | |||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 650752584 |
| Plan administrator’s name | VALLACARE HEALTH SERVICES INC |
| Plan administrator’s address | 517 TAMIAMI TR, STE A, PUNTA GORDA, FL, 33950 |
| Administrator’s telephone number | 9415751333 |
Signature of
| Role | Plan administrator |
| Date | 2012-04-24 |
| Name of individual signing | BLANCA VALLADARES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9415751333 |
| Plan sponsor’s address | 517 TAMIAMI TR, STE A, PUNTA GORDA, FL, 33950 |
Plan administrator’s name and address
| Administrator’s EIN | 650752584 |
| Plan administrator’s name | VALLACARE HEALTH SERVICES INC |
| Plan administrator’s address | 517 TAMIAMI TR, STE A, PUNTA GORDA, FL, 33950 |
| Administrator’s telephone number | 9415751333 |
Signature of
| Role | Plan administrator |
| Date | 2011-06-21 |
| Name of individual signing | BLANCA VALLADARES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9415751333 |
| Plan sponsor’s DBA name | SAME |
| Plan sponsor’s address | 517 TAMIAMI TR, STE A, PUNTA GORDA, FL, 33950 |
Plan administrator’s name and address
| Administrator’s EIN | 650752584 |
| Plan administrator’s name | VALLACARE HEALTH SERVICES INC |
| Plan administrator’s address | 517 TAMIAMI TR, STE A, PUNTA GORDA, FL, 33950 |
| Administrator’s telephone number | 9415751333 |
Signature of
| Role | Plan administrator |
| Date | 2010-12-01 |
| Name of individual signing | BLANCA VALLADARES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| NUTTER, DENVER MD | Agent | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL 33950 |
| Name | Role | Address |
|---|---|---|
| NUTTER, DENVER MD | President | 517 TAMIAMI TRAIL, SUITE A PUNTA GORDA, FL 33950 |
| Name | Role | Address |
|---|---|---|
| NUTTER, DENVER MD | Secretary | 517 TAMIAMI TRAIL, SUITE A PUNTA GORDA, FL 33950 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000045284 | VALLACARE FAMILY PHYSICIANS | EXPIRED | 2010-05-24 | 2015-12-31 | No data | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL, 33950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-08-18 | NUTTER, DENVER MD | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-30 | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL 33950 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-04-30 | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL 33950 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-04-30 | 517 TAMIAMI TRAIL, SUITE A, PUNTA GORDA, FL 33950 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-08-18 |
| ANNUAL REPORT | 2011-04-28 |
| ANNUAL REPORT | 2010-04-14 |
| ANNUAL REPORT | 2009-04-30 |
| ANNUAL REPORT | 2008-04-23 |
| ANNUAL REPORT | 2007-04-12 |
| ANNUAL REPORT | 2006-04-24 |
| ANNUAL REPORT | 2005-04-24 |
| ANNUAL REPORT | 2004-04-30 |
| ANNUAL REPORT | 2003-03-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
