| Entity Name: | AGNES UBANI INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 30 Sep 2004 (20 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 17 Nov 2004 (20 years ago) |
| Document Number: | P04000136112 |
| FEI/EIN Number | 201689923 |
| Address: | 9905 SORBONNE LOOP, SEFFNER, FL, 33584, US |
| Mail Address: | WINDSOR MEDICAL CLINIC, P.O. Box 16722, TEMPLE TERRACE, FL, 33687, US |
| ZIP code: | 33584 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134302748 | 2007-12-06 | 2007-12-18 | PO BOX 16722, TAMPA, FL, 336876722, US | 10320 N 56TH ST, SUITE 120, TEMPLE TERRACE, FL, 336174071, US | |||||||||||||||||
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| Phone | +1 813-341-7900 |
Authorized person
| Name | AGNES UBANI |
| Role | PHYSICIAN |
| Phone | 8133417900 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME 84332 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WINDSOR MEDICAL CLINIC 401(K) PLAN | 2023 | 201689983 | 2024-05-30 | AGNES UBANI INC | 5 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-05-30 |
| Name of individual signing | VICTOR UBANI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8139241880 |
| Plan sponsor’s address | 11434 NORTH 53RD STREET, TAMPA, FL, 33617 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-30 |
| Name of individual signing | VICTOR UBANI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 8139241880 |
| Plan sponsor’s address | 11434 NORTH 53RD STREET, TAMPA, FL, 33617 |
Signature of
| Role | Plan administrator |
| Date | 2022-06-30 |
| Name of individual signing | VICTOR UBANI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Victor Ubani | Agent | 9905 SORBONNE LOOP, SEFFNER, FL, 33584 |
| Name | Role | Address |
|---|---|---|
| UBANI AGNES | President | WINDSOR MEDICAL CLINIC, TEMPLE TERRACE, FL, 33687 |
| Name | Role | Address |
|---|---|---|
| UBANI VICTOR | Director | WINDSOR MEDICAL CLINIC, TEMPLE TERRACE, FL, 33687 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000108047 | WINDSOR MEDICAL CLINIC | ACTIVE | 2015-10-22 | 2025-12-31 | No data | 11434 N 53RD ST, TEMPLE TERRACE, FL, 33617 |
| G08364900022 | WINDSOR MEDICAL CLINIC | EXPIRED | 2008-12-30 | 2013-12-31 | No data | 10320 N. 56TH STREET, #120, TEMPLE TERRACE, FL, 33617 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-12 | 9905 SORBONNE LOOP, SEFFNER, FL 33584 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-12 | Victor, Ubani | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-12 | 9905 SORBONNE LOOP, SEFFNER, FL 33584 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-24 | 9905 SORBONNE LOOP, SEFFNER, FL 33584 | No data |
| AMENDMENT | 2004-11-17 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-01-08 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
