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  5. FANOURIOS I. FERDERIGOS, M.D. P.A

FANOURIOS I. FERDERIGOS, M.D. P.A - Florida Company Profile

Company Details

Entity Name: FANOURIOS I. FERDERIGOS, M.D. P.A
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

FANOURIOS I. FERDERIGOS, M.D. P.A is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 24 Dec 1986 (38 years ago)
Date of dissolution: 23 Sep 2022 (3 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (3 years ago)
Document Number: J50050
FEI/EIN Number 592745575

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 2626 TAMPA ROAD, 103, PALM HARBOR, FL, 34684
Mail Address: 2626 TAMPA ROAD, 103, PALM HARBOR, FL, 34684
ZIP code: 34684
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1225338510 2010-11-02 2015-06-26 2626 TAMPA RD, SUITE 103, PALM HARBOR, FL, 346843155, US 2626 TAMPA RD, SUITE 103, PALM HARBOR, FL, 346843155, US

Contacts
Phone +1 727-789-3300
Fax 7277873454

Authorized person
Name DR. FANOURIOS I. FERDERIGOS
Role PRESIDENT
Phone 7277893300

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
License Number ME0040703
State FL
Is Primary Yes

Other Provider Identifiers
Issuer FEDERAL WORKERS COMP PROV
Number 220139000
State FL
Issuer MEDICARE PTAN
Number GC512A
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FANOURIOS I. FERDERIGOS, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2015 592745575 2016-05-14 FANOURIOS I. FERDERIGOS, M.D., P.A. 1
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2016-05-14
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-14
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M. D. , P. A. PROFIT SHARING PLAN 2015 592745575 2016-05-14 FANOURIOS I. FERDERIGOS, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2016-05-14
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-14
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2015 592745575 2016-05-16 FANOURIOS I. FERDERIGOS, M.D., P.A. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2016-05-16
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-16
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2014 592745575 2015-09-20 FANOURIOS I. FERDERIGOS, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2015-09-20
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-20
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. PROFIT SHARING PLAN 2014 592745575 2015-09-20 FANOURIOS I. FERDERIGOS, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2015-09-20
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-20
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. PROFIT SHARING PLAN 2013 592745575 2014-07-23 FANOURIOS I. FERDERIGOS, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-23
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2013 592745575 2014-07-23 FANOURIOS I. FERDERIGOS, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-23
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. PROFIT SHARING PLAN 2012 592745575 2013-08-28 FANOURIOS I. FERDERIGOS, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2013-08-28
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-28
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2012 592745575 2013-08-28 FANOURIOS I. FERDERIGOS, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2013-08-28
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-28
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
FANOURIOS I. FERDERIGOS, M.D., P.A. PROFIT SHARING PLAN 2011 592745575 2012-07-20 FANOURIOS I. FERDERIGOS, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277717482
Plan sponsor’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677

Plan administrator’s name and address
Administrator’s EIN 592745575
Plan administrator’s name FANOURIOS I. FERDERIGOS, M.D., P.A.
Plan administrator’s address 1344 PRESERVATION WAY, OLDSMAR, FL, 34677
Administrator’s telephone number 7277717482

Signature of
Role Plan administrator
Date 2012-07-20
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-20
Name of individual signing FANOURIOS FERDERIGOS
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
FERDERIGOS FANOURIOS I Manager 2626 TAMPA RD STE 103, PALM HARBOR, FL, 34684
FERDERIGOS FANOURIOS I Director 2626 TAMPA RD STE 103, PALM HARBOR, FL, 34684
Fanourios Ferderigos MD PA Agent 2626 TAMPA ROAD, PALM HARBOR, FL, 34684

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -
REGISTERED AGENT NAME CHANGED 2021-03-03 Fanourios Ferderigos MD PA -
REINSTATEMENT 2021-03-03 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 - -
REINSTATEMENT 2010-12-08 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2010-09-24 - -
CHANGE OF MAILING ADDRESS 2008-04-28 2626 TAMPA ROAD, 103, PALM HARBOR, FL 34684 -
CHANGE OF PRINCIPAL ADDRESS 2008-04-28 2626 TAMPA ROAD, 103, PALM HARBOR, FL 34684 -
REGISTERED AGENT ADDRESS CHANGED 2004-06-30 2626 TAMPA ROAD, PALM HARBOR, FL 34684 -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J13000326927 TERMINATED 1000000470000 PINELLAS 2013-01-30 2023-02-06 $ 1,925.11 STATE OF FLORIDA, DEPARTMENT OF REVENUE, CLEARWATER SERVICE CENTER, 19337 US HIGHWAY 19 N STE 200, CLEARWATER FL337643149

Documents

Name Date
REINSTATEMENT 2021-03-03
ANNUAL REPORT 2019-02-09
ANNUAL REPORT 2018-01-18
ANNUAL REPORT 2017-02-12
ANNUAL REPORT 2016-03-27
ANNUAL REPORT 2015-01-10
ANNUAL REPORT 2014-01-14
ANNUAL REPORT 2013-04-14
ANNUAL REPORT 2012-01-03
ANNUAL REPORT 2011-06-26

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3246077803 2020-05-26 0455 PPP 2626 TAMPA RD, PALM HARBOR, FL, 34684
Loan Status Date 2021-06-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 4165
Loan Approval Amount (current) 4165
Undisbursed Amount 0
Franchise Name -
Lender Location ID 67422
Servicing Lender Name First Horizon Bank
Servicing Lender Address 165 Madison Ave, MEMPHIS, TN, 38103-2723
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PALM HARBOR, PINELLAS, FL, 34684-1000
Project Congressional District FL-13
Number of Employees 1
NAICS code 531390
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 67422
Originating Lender Name First Horizon Bank
Originating Lender Address MEMPHIS, TN
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 4202.6
Forgiveness Paid Date 2021-05-03
5662808508 2021-03-01 0455 PPS 2626 Tampa Rd, Palm Harbor, FL, 34684-3155
Loan Status Date 2022-01-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 4060
Loan Approval Amount (current) 4060
Undisbursed Amount 0
Franchise Name -
Lender Location ID 67422
Servicing Lender Name First Horizon Bank
Servicing Lender Address 165 Madison Ave, MEMPHIS, TN, 38103-2723
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Palm Harbor, PINELLAS, FL, 34684-3155
Project Congressional District FL-13
Number of Employees 1
NAICS code 531390
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 67422
Originating Lender Name First Horizon Bank
Originating Lender Address MEMPHIS, TN
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 4090.22
Forgiveness Paid Date 2021-12-07

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FERDERIGOS FANOURIOS I

WESTSHORE BUSINESS EXECUTIVE CENTER, LLC - Active
Florida Limited Liability Co. (2010 )
EXECUTIVE BUSINESS SERVICE CENTER, LLC - Inactive
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TAMPA BAY CORPORATE SQUARE, LLC - Active
Florida Limited Liability Co. (2012 )

Companies related by address

No other companies in our directory share the same address as FANOURIOS I. FERDERIGOS, M.D. P.A

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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