| Entity Name: | PHYSICIANS COLLABORATIVE ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Mar 2009 (16 years ago) |
| Date of dissolution: | 17 Jan 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 17 Jan 2017 (8 years ago) |
| Document Number: | P09000022792 |
| FEI/EIN Number | 264433180 |
| Address: | 425 W.COLONIAL DRIVE, 302, ORLANDO, FL, 32804 |
| Mail Address: | P.O. BOX 547066, ORLANDO, FL, 32854 |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073754594 | 2009-03-12 | 2013-01-28 | PO BOX 547066, ORLANDO, FL, 328547066, US | 425 W COLONIAL DR, SUITE 302, ORLANDO, FL, 328046863, US | |||||||||||||||||||||||
|
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| Phone | +1 407-362-6003 |
| Fax | 4073626007 |
Authorized person
| Name | SANJEEV SINGH |
| Role | OWNER |
| Phone | 4073626003 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| QADIR AFTAB | Agent | 425 W. COLONIAL DRIVE, ORLANDO, FL, 32804 |
| Name | Role | Address |
|---|---|---|
| QADIR AFTAB | President | P.O. BOX 547066, ORLANDO, FL, 32854 |
| Name | Role | Address |
|---|---|---|
| SINGH SANJEEV | Vice President | P.O. BOX 547066, ORLANDO, FL, 32854 |
| ALLEN LUIS G | Vice President | P.O. BOX 547066, ORLANDO, FL, 32854 |
| Name | Role | Address |
|---|---|---|
| SINGH SURAHBI | Director | P.O. BOX 547066, ORLANDO, FL, 32854 |
| WILLIAMS ALLEN MAXINE E | Director | P.O. BOX 547066, ORLANDO, FL, 32854 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-01-17 | No data | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2017-01-17 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-05 |
| ANNUAL REPORT | 2014-04-22 |
| ANNUAL REPORT | 2013-04-14 |
| ANNUAL REPORT | 2012-04-20 |
| ANNUAL REPORT | 2011-04-05 |
| ANNUAL REPORT | 2010-03-01 |
| Domestic Profit | 2009-03-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
