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  5. SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES PA

SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES PA - Florida Company Profile

Company Details

Entity Name: SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 22 Aug 2006 (19 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 10 Oct 2011 (14 years ago)
Document Number: P06000110062
FEI/EIN Number 205417408

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308
Mail Address: 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308
ZIP code: 32308
County: Leon
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982747838 2007-02-14 2011-10-26 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 323085359, US 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 323085359, US

Contacts
Phone +1 850-942-2299
Fax 8509420322

Authorized person
Name DR. PHILBERT J FORD
Role PHYSICIAN
Phone 8509422299

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME91513
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 275226300
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHARING PLAN 2023 205417408 2024-10-10 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHARING PLAN 2022 205417408 2023-11-01 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHAR 2021 205417408 2022-09-26 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHAR 2020 205417408 2021-10-08 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHAR 2019 205417408 2020-10-10 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHAR 2018 205417408 2019-08-19 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHARING PLAN 2017 205417408 2018-09-17 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHARING PLAN 2016 205417408 2017-10-12 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHARING PLAN 2015 205417408 2016-09-28 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2016-09-28
Name of individual signing TERESA FAULKENBERRY
Valid signature Filed with authorized/valid electronic signature
SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 401(K) PROFIT SHARING PLAN 2014 205417408 2015-09-30 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES, PA 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 8509422299
Plan sponsor’s address 2009 MICCOSUKEE ROAD, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2015-09-30
Name of individual signing TERESA FAULKENBERRY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
FORD PHILBERT J President 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308
FORD PHILBERT J Secretary 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308
FORD PHILBERT J Treasurer 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308
FORD PHILBERT J Director 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308
FORD PHILBERT J Agent 2009 MICCOSUKEE RD, TALLAHASSEE, FL, 32308

Events

Event Type Filed Date Value Description
NAME CHANGE AMENDMENT 2011-10-10 SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES PA -
REGISTERED AGENT ADDRESS CHANGED 2011-01-04 2009 MICCOSUKEE RD, TALLAHASSEE, FL 32308 -
AMENDMENT AND NAME CHANGE 2009-12-18 PHILBERT J. FORD, M.D., P.A. -
CHANGE OF PRINCIPAL ADDRESS 2009-12-18 2009 MICCOSUKEE RD, TALLAHASSEE, FL 32308 -
CHANGE OF MAILING ADDRESS 2009-12-18 2009 MICCOSUKEE RD, TALLAHASSEE, FL 32308 -
REGISTERED AGENT NAME CHANGED 2009-06-03 FORD, PHILBERT JPSTD -

Documents

Name Date
ANNUAL REPORT 2024-02-15
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-02-21
ANNUAL REPORT 2021-02-04
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-03-26
ANNUAL REPORT 2018-01-10
ANNUAL REPORT 2017-01-11
ANNUAL REPORT 2016-01-13
ANNUAL REPORT 2015-01-07

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8682888609 2021-03-25 0491 PPS 2009 Miccosukee Rd, Tallahassee, FL, 32308-5359
Loan Status Date 2021-10-21
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 200718.57
Loan Approval Amount (current) 200718.57
Undisbursed Amount 0
Franchise Name -
Lender Location ID 4392
Servicing Lender Name Centennial Bank
Servicing Lender Address 620 Chestnut St, CONWAY, AR, 72032-5404
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Tallahassee, LEON, FL, 32308-5359
Project Congressional District FL-02
Number of Employees 15
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 4392
Originating Lender Name Centennial Bank
Originating Lender Address CONWAY, AR
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 201488.45
Forgiveness Paid Date 2021-08-23

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Companies related by address

No other companies in our directory share the same address as SOUTHEASTERN CENTER FOR INFECTIOUS DISEASES PA

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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