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  5. HESHAM FAKHRI MD, PLLC

HESHAM FAKHRI MD, PLLC

Company Details

Entity Name: HESHAM FAKHRI MD, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 09 Jun 2016 (9 years ago)
Document Number: L16000112108
FEI/EIN Number 812897472
Address: 508 South Habana Ave, Ste 160, TAMPA, FL, 33609, US
Mail Address: 301 W. Platt St., Ste. A428, Tampa, FL, 33606, US
ZIP code: 33609
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1174047674 2017-07-27 2017-07-27 2605 W SWANN AVE STE 100, TAMPA, FL, 336094039, US 2605 W SWANN AVE STE 100, TAMPA, FL, 336094039, US

Contacts
Phone +1 313-247-4348
Fax 8662709831
Phone +1 813-708-8346

Authorized person
Name HESHAM FAKHRI
Role PRESIDENT
Phone 8137088346

Taxonomy
Taxonomy Code 207RC0000X - Cardiovascular Disease Physician
Is Primary No
Taxonomy Code 207RI0011X - Interventional Cardiology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HESHAM FAKHRI MD PLLC 401(K) PLAN 2023 812897472 2024-05-14 HESHAM FAKHRI MD PLLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8137088346
Plan sponsor’s address 301 W PLATT ST, SUITE A428, TAMPA, FL, 33606

Signature of
Role Plan administrator
Date 2024-05-14
Name of individual signing RANA FAKHRI
Valid signature Filed with authorized/valid electronic signature
HESHAM FAKHRI MD PLLC 401(K) PLAN 2022 812897472 2023-05-17 HESHAM FAKHRI MD PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8137088346
Plan sponsor’s address 301 W PLATT ST, SUITE A428, TAMPA, FL, 33606

Signature of
Role Plan administrator
Date 2023-05-17
Name of individual signing RANA FAKHRI
Valid signature Filed with authorized/valid electronic signature
HESHAM FAKHRI MD PLLC 401(K) PLAN 2021 812897472 2022-06-27 HESHAM FAKHRI MD PLLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8137088346
Plan sponsor’s address 301 W PLATT ST, SUITE A428, TAMPA, FL, 33606

Signature of
Role Plan administrator
Date 2022-06-27
Name of individual signing RANA FAKHRI
Valid signature Filed with authorized/valid electronic signature
HESHAM FAKHRI MD PLLC 401(K) PLAN 2020 812897472 2021-10-04 HESHAM FAKHRI MD PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3135293396
Plan sponsor’s address 508 S HABANA AVE, SUITE 160, TAMPA, FL, 33609

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing RANA FAKHRI
Valid signature Filed with authorized/valid electronic signature
HESHAM FAKHRI MD PLLC 401(K) PLAN 2019 812897472 2020-09-25 HESHAM FAKHRI MD PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8137088346
Plan sponsor’s address 508 S HABANA AVE, SUITE 160, TAMPA, FL, 33609

Agent

Name Role
UNITED STATES CORPORATION AGENTS, INC. Agent

Authorized Member

Name Role Address
FAKHRI HESHAM Authorized Member 2426 W. Sunset Dr., Tampa, FL, 33629

Vice President

Name Role Address
Fakhri Rana Vice President 2426 W.Sunset drive, TAMPA, FL, 33629

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000019764 VEIN, HEART AND VASCULAR INSTITUTE ACTIVE 2017-02-23 2027-12-31 No data 301 W.PLATT STREET, SUITE A 428, TAMPA, FL, 33606

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-02-18 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 No data
CHANGE OF MAILING ADDRESS 2021-03-03 508 South Habana Ave, Ste 160, TAMPA, FL 33609 No data
CHANGE OF PRINCIPAL ADDRESS 2020-01-20 508 South Habana Ave, Ste 160, TAMPA, FL 33609 No data

Documents

Name Date
ANNUAL REPORT 2024-03-04
ANNUAL REPORT 2023-02-15
ANNUAL REPORT 2022-04-04
ANNUAL REPORT 2021-03-03
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-01-14
ANNUAL REPORT 2017-05-01
Florida Limited Liability 2016-06-09

Related by officers

FAKHRI HESHAM

MEDIHAUS MEDICAL SERVICES LLC VEIN, HEART AND VASCULAR @ HOME LLC

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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