| Entity Name: | METROLINA INFECTIOUS DISEASES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Active |
| Date Filed: | 16 Nov 2009 (15 years ago) |
| Document Number: | F09000004502 |
| FEI/EIN Number | 261552359 |
| Address: | 219 Palermo Place, VENICE, FL, 34285, US |
| Mail Address: | 219 Palermo Place, VENICE, FL, 34285, US |
| ZIP code: | 34285 |
| County: | Sarasota |
| Place of Formation: | NORTH CAROLINA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851560478 | 2008-02-28 | 2022-06-02 | 219 PALERMO PL, VENICE, FL, 342852821, US | 219 PALERMO PL, VENICE, FL, 342852821, US | |||||||||||||||||||
|
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| Phone | +1 941-244-9524 |
| Fax | 9412449526 |
Authorized person
| Name | DR. AHMED OMER FAROOQ |
| Role | PRESIDENT/PHYSICIAN |
| Phone | 9803287590 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 2005-00638 |
| State | NC |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Farooq Ahmed O | Agent | 219 Palermo Place, VENICE, FL, 34285 |
| Name | Role | Address |
|---|---|---|
| FAROOQ AHMED O | President | 219 Palermo Place, VENICE, FL, 34285 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-13 | 219 Palermo Place, VENICE, FL 34285 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-13 | 219 Palermo Place, VENICE, FL 34285 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-13 | 219 Palermo Place, VENICE, FL 34285 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-05-21 | Farooq, Ahmed Omer | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-04-08 |
| AMENDED ANNUAL REPORT | 2018-05-21 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-02-28 |
| ANNUAL REPORT | 2016-03-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
