| Entity Name: | ZWEIBACH & CHAMPION, M.D.S, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Feb 2003 (22 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P03000023767 |
| FEI/EIN Number | 331042095 |
| Address: | 515 S Kings Ave, BRANDON, FL, 33511, US |
| Mail Address: | 515 S Kings Ave, BRANDON, FL, 33511, US |
| ZIP code: | 33511 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437255650 | 2006-09-15 | 2012-10-25 | 815 S PARSONS AVE, BRANDON, FL, 335116063, US | 815 S PARSONS AVE, BRANDON, FL, 335116063, US | |||||||||||||||||||||||||
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| Phone | +1 813-571-2777 |
| Fax | 8135712888 |
Authorized person
| Name | DR. STEPHEN M ZWEIBACH |
| Role | OWNER |
| Phone | 8135712777 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 154572.0000 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274786300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ZWEIBACH STEPHEN MM.D. | Agent | 815 S. PARSONS AVE., BRANDON, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| Champion Natasha J | President | 5107 Durham Creek Pl, Brandon, FL, 33511 |
| Name | Role | Address |
|---|---|---|
| ZWEIBACH STEPHEN M | Vice President | 2109 BRANDON PARK CIR, BRANDON, FL, 33510 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000005208 | WOMEN'S HEALTH & WELLNESS | EXPIRED | 2014-01-14 | 2019-12-31 | No data | 815 S PARSONS AVENUE, BRANDON, FL, 33511 |
| G12000082768 | WOMEN'S HEALTH AND WELLNESS | EXPIRED | 2012-08-21 | 2017-12-31 | No data | 815 S. PARSON'S AVE, BRANDON, FL, 33511 |
| G11000111479 | ZWEIBACH WOMEN'S HEALTH | EXPIRED | 2011-11-16 | 2016-12-31 | No data | 815 S PARSONS AVE, BRANDON, FL, 33511 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-28 | 515 S Kings Ave, BRANDON, FL 33511 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-28 | 515 S Kings Ave, BRANDON, FL 33511 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-02-13 | ZWEIBACH, STEPHEN M, M.D. | No data |
| NAME CHANGE AMENDMENT | 2012-09-20 | ZWEIBACH & CHAMPION, M.D.S, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-10 | 815 S. PARSONS AVE., BRANDON, FL 33511 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-02-21 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-04-16 |
| ANNUAL REPORT | 2014-03-07 |
| ANNUAL REPORT | 2013-02-13 |
| Name Change | 2012-09-20 |
| ANNUAL REPORT | 2012-04-06 |
| ANNUAL REPORT | 2011-03-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
