| Entity Name: | MEDICAL VILLAGE HEALTHCARE GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 May 2005 (20 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 20 Dec 2006 (18 years ago) |
| Document Number: | P05000076594 |
| FEI/EIN Number | 202909178 |
| Address: | 1462 W. Oak Ridge Road, Orlando, FL, 32809, US |
| Mail Address: | 1462 W. OAK RIDGE ROAD, ORLANDO, FL, 32809, US |
| ZIP code: | 32809 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861630626 | 2009-01-31 | 2009-02-02 | 816 W OAK ST, KISSIMMEE, FL, 347416625, US | 1462 W OAK RIDGE RD, ORLANDO, FL, 328093905, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-944-9777 |
| Phone | +1 407-888-6990 |
| Fax | 4078883310 |
Authorized person
| Name | DR. KHALID MANZUR |
| Role | PRESIDENT |
| Phone | 4078886990 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME81287 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME81287 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL PROVIDER NPI |
| Number | 1376516575 |
| State | FL |
| Issuer | INDIVIDUAL PROVIDER NPI |
| Number | 1447223193 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MANZUR NAGHMA | Agent | 8931 SOUTHERN BREEZE DRIVE, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| MANZUR KHALID | Director | 1462 W. OAK RIDGE ROAD, ORLANDO, FL, 32809 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-03-28 | MANZUR, NAGHMA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-28 | 8931 SOUTHERN BREEZE DRIVE, ORLANDO, FL 32836 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-28 | 1462 W. Oak Ridge Road, Orlando, FL 32809 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-13 | 1462 W. Oak Ridge Road, Orlando, FL 32809 | No data |
| CANCEL ADM DISS/REV | 2006-12-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-28 |
| ANNUAL REPORT | 2023-02-06 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-03-07 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-01 |
| ANNUAL REPORT | 2017-03-08 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
