| Entity Name: | DAVENPORT PEDIATRICS CLERMONT, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Feb 2006 (19 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 07 Nov 2008 (16 years ago) |
| Document Number: | P06000027223 |
| FEI/EIN Number | 204376807 |
| Address: | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| Mail Address: | 8798 DARLENE DR, ORLANDO, FL, 32836 |
| ZIP code: | 34714 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700021508 | 2008-12-08 | 2011-07-18 | 1528 SUNRISE PLAZA DR STE 1, CLERMONT, FL, 347146203, US | 1528 SUNRISE PLAZA DR STE 1, CLERMONT, FL, 347146203, US | |||||||||||||||
|
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| Phone | +1 352-394-7728 |
| Fax | 3523946369 |
Authorized person
| Name | DR. JAMIL H KHAN |
| Role | PHYSICIAN |
| Phone | 3523947728 |
Taxonomy
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KHAN JAMIL H | Agent | 8798 DARLENE DR, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| KHAN JAMIL H. | Director | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| KHAN MARIA CRISTINAC | Director | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| Name | Role | Address |
|---|---|---|
| KHAN JAMIL H. | President | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| KHAN MARIA CRISTINAC | President | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| Name | Role | Address |
|---|---|---|
| KHAN JAMIL H. | Secretary | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| KHAN MARIA CRISTINAC | Secretary | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| Name | Role | Address |
|---|---|---|
| KHAN JAMIL H. | Treasurer | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| KHAN MARIA CRISTINAC | Treasurer | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08266900472 | DAVENPORT PEDIATRICS, CLERMONT | EXPIRED | 2008-09-22 | 2013-12-31 | No data | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL, 34714 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2008-11-07 | DAVENPORT PEDIATRICS CLERMONT, P.A. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-03-02 | 1528 SUNRISE PLAZA DRIVE, SUITE 1, CLERMONT, FL 34714 | No data |
| NAME CHANGE AMENDMENT | 2007-02-15 | JAMIL H. KHAN, M.D., P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-15 |
| ANNUAL REPORT | 2023-02-11 |
| ANNUAL REPORT | 2022-04-09 |
| ANNUAL REPORT | 2021-01-25 |
| ANNUAL REPORT | 2020-02-09 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-16 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-02-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
