| Entity Name: | BAY INFECTIOUS DISEASE, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Sep 2014 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Jan 2018 (7 years ago) |
| Document Number: | L14000149298 |
| FEI/EIN Number | 36-4799830 |
| Address: | 750 Harrison Ave, Panama City, FL, 32401, US |
| Mail Address: | PO BOX 1442, LYNN HAVEN, FL, 32444 |
| ZIP code: | 32401 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366831810 | 2015-01-21 | 2015-06-15 | 750 HARRISON AVE, PANAMA CITY, FL, 324012524, US | 750 HARRISON AVE, PANAMA CITY, FL, 324012524, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 850-913-9294 |
Authorized person
| Name | IKRAM HAQ |
| Role | MD |
| Phone | 8509139294 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| License Number | ME0075189 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014620600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAQ IKRAM | Agent | 750 HARISON AVE, PANAMA CITY, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| Haq Ikram | Manager | 750 Harrison Avenue, Panama City, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| Ait Jalloul Aimee | Auth | 750 Harrison Avenue, Panama City, FL, 32401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-15 | 750 Harrison Ave, Panama City, FL 32401 | No data |
| REINSTATEMENT | 2018-01-23 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REINSTATEMENT | 2016-02-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-21 | HAQ, IKRAM | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-15 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-03-19 |
| ANNUAL REPORT | 2020-01-30 |
| ANNUAL REPORT | 2019-01-21 |
| REINSTATEMENT | 2018-01-23 |
| REINSTATEMENT | 2016-02-21 |
| Florida Limited Liability | 2014-09-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
