| Entity Name: | CENTRAL FLORIDA INJURY SOUTHWEST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Jul 2009 (16 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 08 Oct 2019 (5 years ago) |
| Document Number: | P09000063694 |
| FEI/EIN Number | 270789814 |
| Address: | 8370 West Hillsborough Ave, Ste 103, Tampa, FL, 33615, US |
| Mail Address: | P.O. Box 263491, Tampa, FL, 33685, US |
| ZIP code: | 33615 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780911925 | 2009-11-09 | 2016-06-08 | 882 S KIRKMAN RD STE 101, ORLANDO, FL, 328112652, US | 882 S KIRKMAN RD STE 101, ORLANDO, FL, 328112652, US | |||||||||||||||||||||||||||||
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| Phone | +1 407-578-2350 |
| Fax | 4072648300 |
Authorized person
| Name | MR. JEROLD J FADEM JR. |
| Role | PHYSICIAN |
| Phone | 4075782351 |
Taxonomy
| Taxonomy Code | 204D00000X - Neuromusculoskeletal Medicine & OMM Physician |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| McMahon, Esq. Gregory P | Agent | 618 East South Street, Orlando, FL, 32801 |
| Name | Role | Address |
|---|---|---|
| Patel Bhararkumar | President | P.O. Box 263491, Tampa, FL, 33685 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-30 | 8370 West Hillsborough Ave, Ste 103, Tampa, FL 33615 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-30 | 8370 West Hillsborough Ave, Ste 103, Tampa, FL 33615 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-21 | 618 East South Street, Ste 500, Orlando, FL 32801 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-03-21 | McMahon, Esq., Gregory P | No data |
| NAME CHANGE AMENDMENT | 2019-10-08 | CENTRAL FLORIDA INJURY SOUTHWEST, INC. | No data |
| NAME CHANGE AMENDMENT | 2019-01-17 | INJURY REHABILITATION CLINICS OF CENTRAL FLORIDA SOUTHWEST, INC. | No data |
| AMENDMENT | 2017-08-24 | No data | No data |
| AMENDMENT | 2017-03-17 | No data | No data |
| AMENDMENT | 2016-08-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-30 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-02-18 |
| ANNUAL REPORT | 2020-01-02 |
| Name Change | 2019-10-08 |
| Name Change | 2019-01-17 |
| ANNUAL REPORT | 2019-01-02 |
| ANNUAL REPORT | 2018-01-05 |
| Amendment | 2017-08-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
