| Entity Name: | ORAL & FACIAL SURGERY OF FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Mar 2009 (16 years ago) |
| Document Number: | P09000027291 |
| FEI/EIN Number | 264536912 |
| Address: | 19051 US HWY 441,, SUITE 100, MOUNT DORA, FL, 32757, US |
| Mail Address: | 19051 US HWY 441,, SUITE 100, MOUNT DORA, FL, 32757, US |
| ZIP code: | 32757 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760722474 | 2013-02-18 | 2013-02-18 | 801 CHAMPION WOODS CT, SANFORD, FL, 327717164, US | 19051 US HIGHWAY 441, SUITE 104, MOUNT DORA, FL, 327576708, US | |||||||||||||||||
|
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| Phone | +1 407-756-7172 |
Authorized person
| Name | DR. ABDUL MAJID AZIZI |
| Role | OWNER/SURGEON |
| Phone | 4077567172 |
Taxonomy
| Taxonomy Code | 261QS0112X - Oral and Maxillofacial Surgery Clinic/Center |
| License Number | DN15621 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AZIZI ABDUL M | Agent | 19051 US HWY 441,, MOUNT DORA, FL, 32757 |
| Name | Role | Address |
|---|---|---|
| AZIZI ABDUL M | President | 709 Cricklewood Terrace, Lake Mary, FL, 32746 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000014452 | LAKE ORAL AND MAXILLOFACIAL SURGERY | ACTIVE | 2012-02-09 | 2027-12-31 | No data | 19051 US HWY 441, STE 100, MOUNT DORA, FL, 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-09 | 19051 US HWY 441,, SUITE 100, MOUNT DORA, FL 32757 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-07-10 | 19051 US HWY 441,, SUITE 100, MOUNT DORA, FL 32757 | No data |
| CHANGE OF MAILING ADDRESS | 2013-07-10 | 19051 US HWY 441,, SUITE 100, MOUNT DORA, FL 32757 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-21 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
