| Entity Name: | UROLOGY HEALTHCARE OF CENTRAL FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Jun 2000 (25 years ago) |
| Date of dissolution: | 08 Dec 2022 (2 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 08 Dec 2022 (2 years ago) |
| Document Number: | P00000060554 |
| FEI/EIN Number | 593654437 |
| Address: | 9134 Great Heron Circle, Orlando, FL, 32836, US |
| Mail Address: | 9134 GREAT HERON CIRCLE, ORLANDO, FL, 32836, US |
| ZIP code: | 32836 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124037007 | 2006-08-07 | 2021-02-18 | 2217 NORTH BOULEVARD WEST, DAVENPORT, FL, 33837, US | 2217 NORTH BOULEVARD WEST, DAVENPORT, FL, 33837, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-421-3456 |
| Fax | 8634213466 |
Authorized person
| Name | DR. FAIYAAZ MUSTANSIR JHAVERI |
| Role | CEO |
| Phone | 8634213456 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| License Number | ME0080612 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED HEALTHCARE |
| Number | 1900258 |
| State | FL |
| Issuer | MEDICARE GROUP NUMBER |
| Number | K1998 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JHAVERI FAIYAAZ M | Agent | 9134 GREAT HERON CIRCLE, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| JHAVERI FAIYAAZ M | Director | 9134 GREAT HERON CIRCLE, ORLANDO, FL, 32836 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-12-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-02 | 9134 Great Heron Circle, Orlando, FL 32836 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-02 | 9134 Great Heron Circle, Orlando, FL 32836 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-02 | 9134 GREAT HERON CIRCLE, ORLANDO, FL 32836 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-12-08 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-03-09 |
| ANNUAL REPORT | 2019-02-25 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-03-19 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-03-24 |
| ANNUAL REPORT | 2014-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
