| Entity Name: | GULF COAST INFECTIOUS DISEASES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Apr 2006 (19 years ago) |
| Document Number: | P06000057220 |
| FEI/EIN Number | 204744987 |
| Address: | 8354 North Davis Hwy, PENSACOLA, FL, 32514, US |
| Mail Address: | P O BOX 11640, PENSACOLA, FL, 32524 |
| ZIP code: | 32514 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437109733 | 2006-05-10 | 2020-07-05 | PO BOX 11640, PENSACOLA, FL, 32524, US | 2120 E JOHNSON AVE, PENSACOLA, FL, 32514, US | |||||||||||||||||||||||||||
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| Phone | +1 850-549-4755 |
| Fax | 8505494760 |
Authorized person
| Name | PARDEEP KUMARI |
| Role | PRESIDENT |
| Phone | 8505494755 |
Taxonomy
| Taxonomy Code | 207RI0200X - Infectious Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DEPT OF LABOR |
| Number | 611374600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 529928850 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GULF COAST INFECTIOUS DISEASES, INC. 401(K) PLAN | 2022 | 204744987 | 2023-10-16 | GULF COAST INFECTIOUS DISEASES, INC. | 13 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-10-16 |
| Name of individual signing | PARDEEP KUMARI, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8505494755 |
| Plan sponsor’s address | 2120 E. JOHNSON AVENUE, PENSACOLA, FL, 32514 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-16 |
| Name of individual signing | PARDEEP KUMARI, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8505494755 |
| Plan sponsor’s address | 2120 E. JOHNSON AVENUE, PENSACOLA, FL, 32514 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-06 |
| Name of individual signing | PARDEEP KUMARI, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8505494755 |
| Plan sponsor’s address | 2120 E. JOHNSON AVENUE, PENSACOLA, FL, 32514 |
Signature of
| Role | Plan administrator |
| Date | 2020-09-08 |
| Name of individual signing | PARDEEP KUMARI, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| KUMARI PARDEEP | Agent | 4165 Montalvo, PENSACOLA, FL, 32504 |
| Name | Role | Address |
|---|---|---|
| KUMARI PARDEEP | President | 4165 Montalvo, Pensacola, FL, 32504 |
| Name | Role | Address |
|---|---|---|
| KUMARI PARDEEP | Secretary | 4165 Montalvo, Pensacola, FL, 32504 |
| Name | Role | Address |
|---|---|---|
| KUMARI PARDEEP | Treasurer | 4165 Montalvo, Pensacola, FL, 32504 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-29 | 8354 North Davis Hwy, PENSACOLA, FL 32514 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-16 | 4165 Montalvo, PENSACOLA, FL 32504 | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-15 | 8354 North Davis Hwy, PENSACOLA, FL 32514 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-01-15 | KUMARI, PARDEEP | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-27 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-02-20 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-22 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
