| Entity Name: | TASMINA SHEIKH, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Aug 2003 (22 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 28 Oct 2004 (20 years ago) |
| Document Number: | P03000093564 |
| FEI/EIN Number | 743102661 |
| Address: | 4600 MILITARY TRL, 221, JUPITER, FL, 33458 |
| Mail Address: | 4600 MILITARY TRL, 221, JUPITER, FL, 33458 |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366567166 | 2007-03-20 | 2023-03-07 | 4600 MILITARY TRAIL, STE 221, JUPITER, FL, 334584813, US | 4600 MILITARY TRAIL, STE 221, JUPITER, FL, 334584813, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-625-9695 |
| Fax | 5616259745 |
Authorized person
| Name | TASMINA SHEIKH |
| Role | OWNER |
| Phone | 5616259695 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME0080404 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 06027 |
| State | FL |
| Issuer | MEDICAID |
| Number | 262302100 |
| State | FL |
| Issuer | FL LICENSE |
| Number | ME0080404 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHEIKH TASMINA | Agent | 4600 MILITARY TRAIL, JUPITER, FL, 33458 |
| Name | Role | Address |
|---|---|---|
| SHEIKH TASMINA | President | 4600 MILITARY TRL STE 221, JUPITER, FL, 33458 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000074280 | PALM ATLANTIC PSYCHIATRY | ACTIVE | 2020-06-30 | 2025-12-31 | No data | 4600 MILITARY TRAIL, SUITE 221, JUPITER, FL, 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-27 | 4600 MILITARY TRAIL, 221, JUPITER, FL 33458 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-03 | 4600 MILITARY TRL, 221, JUPITER, FL 33458 | No data |
| CHANGE OF MAILING ADDRESS | 2007-04-03 | 4600 MILITARY TRL, 221, JUPITER, FL 33458 | No data |
| CANCEL ADM DISS/REV | 2004-10-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-22 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-03-18 |
| ANNUAL REPORT | 2021-03-03 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-03-15 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-02-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2980997405 | 2020-05-06 | 0455 | PPP | 4600 MILITARY TRL STE 221, JUPITER, FL, 33458-4813 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8301378410 | 2021-02-13 | 0455 | PPS | 4600 Military Trl Ste 221, Jupiter, FL, 33458-4813 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
