| Entity Name: | FLORIDA HOSPITAL WATERMAN INDEPENDENT PRACTICE ASSOCIATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Active |
| Date Filed: | 17 Oct 1994 (30 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 28 Jan 2008 (17 years ago) |
| Document Number: | N94000005122 |
| FEI/EIN Number | 59-3275588 |
| Address: | 1000 WATERMAN WAY, MANAGED CARE DEPT., TAVARES, FL 32778 |
| Mail Address: | PO Box 253, TAVARES, FL 32778 |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| Sheridan, Jeffrey MD, President | Agent | 1301 South Bay Street, Eustis, FL 32726 |
| Name | Role | Address |
|---|---|---|
| Sheridan, Jeffrey, Dr. | President | 1301 South Bay Street, Eustis, FL 32726 |
| Name | Role | Address |
|---|---|---|
| Sheridan, Jeffrey, Dr. | Director | 1301 South Bay Street, Eustis, FL 32726 |
| PILLOW, STEVEN E, Dr. | Director | 18450 C US HWY 441, MOUNT DORA, FL 32748 |
| Name | Role | Address |
|---|---|---|
| PILLOW, STEVEN E, Dr. | Treasurer | 18450 C US HWY 441, MOUNT DORA, FL 32748 |
| Name | Role | Address |
|---|---|---|
| MASSEY, TINA | Other | 1000 WATERMAN WAY, MANAGED CARE DEPT. TAVARES, FL 32778 |
| Name | Role | Address |
|---|---|---|
| MASSEY, TINA | MANAGER | 1000 WATERMAN WAY, MANAGED CARE DEPT. TAVARES, FL 32778 |
| Name | Role | Address |
|---|---|---|
| Cooke, Andrew, MD | Vice President | 1822 Salk Avenue, TAVARES, FL 32778 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000035126 | FLORIDA INDEPENDENT PRACTICE ASSOCIATION | ACTIVE | 2024-03-08 | 2029-12-31 | No data | P.O. BOX 253, TAVARES, FL, 32778 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-01-31 | 1000 WATERMAN WAY, MANAGED CARE DEPT., TAVARES, FL 32778 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-31 | Sheridan, Jeffrey MD, President | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-31 | 1301 South Bay Street, Eustis, FL 32726 | No data |
| CANCEL ADM DISS/REV | 2008-01-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-02-17 | 1000 WATERMAN WAY, MANAGED CARE DEPT., TAVARES, FL 32778 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-17 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-02-16 |
| ANNUAL REPORT | 2020-03-10 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
