| Entity Name: | MICHEL HABASHY MD P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Feb 2002 (23 years ago) |
| Document Number: | P02000017015 |
| FEI/EIN Number | 01-0640048 |
| Address: | 920 Rolling Acres Road, Unit 208, Lady Lake, FL, 32159, US |
| Mail Address: | 920 Rolling Acres Road, Unit 208, Lady Lake, FL, 32159, US |
| ZIP code: | 32159 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285829408 | 2007-09-11 | 2010-08-09 | 918 ROLLING ACRES RD, SUITE 6, LADY LAKE, FL, 321595027, US | 918 ROLLING ACRES RD, SUITE 6, LADY LAKE, FL, 321595027, US | |||||||||||||||||||||
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| Phone | +1 352-259-9970 |
| Fax | 3522599971 |
Authorized person
| Name | MR. MICHEL S HABASHY |
| Role | OWNER |
| Phone | 3522599970 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBSFLORIDA |
| Number | 13198 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HABASHY MICHEL | Agent | 920 Rolling Acres Road, Lady Lake, FL, 32159 |
| Name | Role | Address |
|---|---|---|
| Clough April office | offi | 920 Rolling Acres Road, Lady Lake, FL, 32159 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-07 | 920 Rolling Acres Road, Unit 208, Lady Lake, FL 32159 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-07 | 920 Rolling Acres Road, Unit 208, Lady Lake, FL 32159 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-02-07 | HABASHY, MICHEL | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-07 | 920 Rolling Acres Road, Unit 208, Lady Lake, FL 32159 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-04-12 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-04-25 |
| ANNUAL REPORT | 2016-04-04 |
| ANNUAL REPORT | 2015-02-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
