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MITCHELL FORMAN, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: MITCHELL FORMAN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

MITCHELL FORMAN, M.D., P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.

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: 17 Mar 2003 (22 years ago)
Date of dissolution: 17 Jan 2014 (11 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 17 Jan 2014 (11 years ago)
Document Number: P03000032188
FEI/EIN Number 710937927

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL, 33544
Mail Address: 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL, 33544
ZIP code: 33544
County: Pasco
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
FORMAN MITCHELL Director 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL, 33544
FORMAN PATRICIA Officer 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL, 33544
FORMAN MITCHELL Agent 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL, 33544

National Provider Identifier

NPI Number:
1720392558

Authorized Person:

Name:
MITCHELL FORMAN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QU0200X - Urgent Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8138668890

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2014-01-17 - -
REGISTERED AGENT ADDRESS CHANGED 2012-01-05 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL 33544 -
CHANGE OF PRINCIPAL ADDRESS 2011-01-06 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL 33544 -
CHANGE OF MAILING ADDRESS 2011-01-06 1644 BRUCE B DOWNS, WESLEY CHAPEL, FL 33544 -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J11000514245 TERMINATED 1000000228497 HILLSBOROU 2011-08-05 2021-08-10 $ 965.85 STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 6302 E DR MARTIN LUTHER KING JR BLVD S, TAMPA FL336191166

Documents

Name Date
VOLUNTARY DISSOLUTION 2014-01-17
ANNUAL REPORT 2013-04-30
ANNUAL REPORT 2012-01-05
ANNUAL REPORT 2011-01-06
ANNUAL REPORT 2010-01-11
ANNUAL REPORT 2009-01-16
ANNUAL REPORT 2008-01-16
ANNUAL REPORT 2007-01-04
ANNUAL REPORT 2006-01-31
ANNUAL REPORT 2005-07-01

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Date of last update: 03 Jun 2025

Sources: Florida Department of State