| Entity Name: | SHAHID ALI IQBAL, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Dec 2008 (16 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 18 Jan 2010 (15 years ago) |
| Document Number: | P08000106991 |
| FEI/EIN Number | 263842838 |
| Address: | 5516 HANLEY ROAD, TAMPA, FL, 33634, US |
| Mail Address: | 5516 HANLEY ROAD, TAMPA, FL, 33634, US |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508159740 | 2011-05-20 | 2020-10-23 | 5516 HANLEY RD, TAMPA, FL, 336344904, US | 5516 HANLEY RD, TAMPA, FL, 336344904, US | |||||||||||||||||||||||||
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| Phone | +1 813-876-0502 |
| Fax | 8138726503 |
Authorized person
| Name | DR. SHAHID IQBAL |
| Role | PRESIDENT |
| Phone | 8138380472 |
Taxonomy
| Taxonomy Code | 207K00000X - Allergy & Immunology Physician |
| License Number | ME 0080570 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101817700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WALKER GARY | Agent | 202 S. ROME AVENUE, TAMPA, FL, 33606 |
| Name | Role | Address |
|---|---|---|
| IQBAL SHAHID A | President | 5516 HANLEY ROAD, TAMPA, FL, 33634 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000125980 | FLORIDA ALLERGY & ASTHMA CARE | ACTIVE | 2022-10-07 | 2027-12-31 | No data | 5516 HANLEY RD, TAMPA, FL, 33634 |
| G11000007239 | FLORIDA ALLERGY & ASTHMA CARE | EXPIRED | 2011-01-18 | 2016-12-31 | No data | C/O SHAHID ALI IQBAL, MD, PA, 4695 VAN DYKE ROAD, LUTZ, FL, 33558 |
| G08345900194 | FLORIDA ALLERGY & ASTHMA MEDICAL CENTER | EXPIRED | 2008-12-10 | 2013-12-31 | No data | 25401 GEDDY DRIVE, LAND O LAKES, FL, 34639 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-22 | 5516 HANLEY ROAD, TAMPA, FL 33634 | No data |
| CHANGE OF MAILING ADDRESS | 2016-04-22 | 5516 HANLEY ROAD, TAMPA, FL 33634 | No data |
| CANCEL ADM DISS/REV | 2010-01-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-06-12 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-17 |
| ANNUAL REPORT | 2017-03-24 |
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-01-21 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5586377304 | 2020-04-30 | 0455 | PPP | 5516 HANLEY RD, TAMPA, FL, 33634-4904 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Feb 2025
Sources: Florida Department of State
