Detail by Officer/Registered Agent Name

Florida Not For Profit Corporation

COUNTRYSIDE WEST MEDICAL CLINIC ASSOCIATION, INC.

Filing Information
N06000009084 20-5568596 08/25/2006 FL ACTIVE AMENDMENT 10/03/2006 NONE
Principal Address
3190 MCMULLEN BOOTH ROAD
CLEARWATER, FL 33761

Changed: 05/10/2007
Mailing Address
3248 MASTERS DRIVE
CLEARWATER, FL 33761

Changed: 05/10/2007
Registered Agent Name & Address TRAUB, JOEL
3248 MASTERS DRIVE
CLEARWATER, FL 33761

Name Changed: 03/16/2023

Address Changed: 05/10/2007
Officer/Director Detail Name & Address

Title President

Mallon, Andrew, Dr.
3190 MCMULLEN BOOTH ROAD
100
CLEARWATER, FL 33761

Title Treasurer

MADAN, SANJAY DR
3190 MCMULLEN BOOTH ROAD
201
CLEARWATER, FL 33761

Title Secretary

Schneider, Jean-Raphael, Dr.
3190 McMullen Booth Rd
200
CLEARWATER, FL 33761

Title Manager

Traub, Joel
3248 Masters Drive
Clearwater, FL 33761

Annual Reports
Report YearFiled Date
2021 03/15/2021
2022 04/19/2022
2023 03/16/2023