| Entity Name: | FLORIDA PANHANDLE PEDIATRIC FOUNDATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| 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 Aug 1992 (33 years ago) |
| Date of dissolution: | 27 Sep 2019 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (6 years ago) |
| Document Number: | N50652 |
| FEI/EIN Number |
593143464
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 802 N LONGWOOD CIRCLE, PANAMA CITY, FL, 32405, US |
| Mail Address: | P O Box 2114, Lynn Haven, FL, 32444, US |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962478230 | 2006-02-27 | 2009-03-12 | 2814 W 15TH ST, PANAMA CITY, FL, 324011376, US | 2814 W 15TH ST, PANAMA CITY, FL, 324011376, US | |||||||||||||||||||||||||||||||
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| Phone | +1 850-872-4840 |
| Fax | 8508724468 |
Authorized person
| Name | MS. PATTI A. WELCH |
| Role | PROJECT ADMINISTRATOR |
| Phone | 8508724840 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 371185401 |
| State | FL |
| Issuer | MEDICAID |
| Number | 371185400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BAKER, M.D. MOHAMED | President | 2420 JENKS AVE, SUITE 3, PANAMA CITY, FL |
| BAKER, M.D. MOHAMED | Director | 2420 JENKS AVE, SUITE 3, PANAMA CITY, FL |
| ALBIBI RASHDA M.D. | Director | 200 W 19 ST, PANAMA CITY, FL |
| HUTCHINSON EDWARD A | Secretary | 221 MCKENZIE AVENUE, PANAMA CITY, FL, 32402 |
| HUTCHINSON EDWARD A | Director | 221 MCKENZIE AVENUE, PANAMA CITY, FL, 32402 |
| HUTCHISON EDWARD A | Treasurer | 221 MCKENZIE AVENUE, PANAMA CITY, FL, 32402 |
| HUTCHISON EDWARD A | Director | 221 MCKENZIE AVENUE, PANAMA CITY, FL, 32402 |
| BAKER M.D. MOHAMED | Agent | 2420 JENKS AVE, PANAMA CITY, FL, 32405 |
| ALBIBI RASHDA M.D. | Vice President | 200 W 19 ST, PANAMA CITY, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-20 | 802 N LONGWOOD CIRCLE, PANAMA CITY, FL 32405 | - |
| CHANGE OF MAILING ADDRESS | 2015-03-31 | 802 N LONGWOOD CIRCLE, PANAMA CITY, FL 32405 | - |
| REGISTERED AGENT NAME CHANGED | 2012-03-20 | BAKER M.D., MOHAMED | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-03-20 | 2420 JENKS AVE, SUITE 3, PANAMA CITY, FL 32405 | - |
| AMENDMENT | 2002-03-04 | - | - |
| AMENDMENT | 1993-02-17 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-05-09 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-03-31 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-03-12 |
| ANNUAL REPORT | 2012-03-20 |
| ANNUAL REPORT | 2011-03-15 |
| ANNUAL REPORT | 2010-03-03 |
| ANNUAL REPORT | 2009-03-23 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
