| Entity Name: | FARHAN SIDDIQI, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Jan 2010 (15 years ago) |
| Date of dissolution: | 15 Jan 2025 (25 days ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 15 Jan 2025 (25 days ago) |
| Document Number: | P10000003900 |
| FEI/EIN Number | 271689066 |
| Address: | 2040 SHORT AVE., SUITE 100, ODESSA, FL, 33556 |
| Mail Address: | 11319 Cortez Boulevard, Brooksville, FL, 34613, US |
| ZIP code: | 33556 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003672700 | 2024-02-21 | 2024-02-21 | 11319 CORTEZ BLVD, BROOKSVILLE, FL, 34613, US | 2309 CREST OVER LN, WESLEY CHAPEL, FL, 33544, US | |||||||||||||||||
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| Phone | +1 352-597-0907 |
| Fax | 3525972243 |
| Phone | +1 727-807-2476 |
Authorized person
| Name | FARHAN N SIDDIQI |
| Role | PRESIDENT |
| Phone | 7278072476 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FARHAN SIDDIQI, MD, PA 401(K) PROFIT SHARING PLAN | 2023 | 271689066 | 2025-01-09 | FARHAN SIDDIQI, MD, PA | 88 | |||||||||||||
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| FARHAN SIDDIQI, MD, PA 401(K) PROFIT SHARING PLAN | 2022 | 271689066 | 2023-10-02 | FARHAN SIDDIQI, MD, PA | 87 | |||||||||||||
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| FARHAN SIDDIQI, MD, PA 401(K) PROFIT SHARING PLAN | 2021 | 271689066 | 2022-08-29 | FARHAN SIDDIQI, MD, PA | 73 | |||||||||||||
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| FARHAN SIDDIQI, MD, PA 401(K) PROFIT SHARING PLAN | 2020 | 271689066 | 2021-09-26 | FARHAN SIDDIQI, MD, PA | 58 | |||||||||||||
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| FARHAN SIDDIQI, MD, PA 401(K) PROFIT SHARING PLAN | 2019 | 271689066 | 2020-10-14 | FARHAN SIDDIQI, MD, PA | 39 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| SIDDIQI FARHAN | Agent | 2040 SHORT AVE, ODESSA, FL, 33556 |
| Name | Role | Address |
|---|---|---|
| SIDDIQI FARHAN | President | 2040 SHORT AVE., ODESSA, FL, 33556 |
| Name | Role | Address |
|---|---|---|
| Wijnmaalen Johannes H | Mgr | 2040 Short Avenue, Odessa, FL, 33556 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000125773 | FLORIDA ADVANCED SPINE AND ORTHOPEDICS | ACTIVE | 2022-10-06 | 2027-12-31 | No data | 11319 CORTEZ BOULEVARD, NEW PORT RICHEY, FL, 34655 |
| G22000050259 | ELITE WOMEN'S CARE | ACTIVE | 2022-04-20 | 2027-12-31 | No data | 11319 CORTEZ BLVD,, BROOKSVILLE, FL, 34613 |
| G19000119289 | FASTMD | ACTIVE | 2019-11-05 | 2029-12-31 | No data | 11319 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| G17000082447 | FLORIDA ADVANCED SPINE, SPORTS AND TRAUMA CENTERS | EXPIRED | 2017-08-02 | 2022-12-31 | No data | 7005 NIGHTWALKER ROAD, BROOKSVILLE, FL, 34613 |
| G17000082446 | F.A.S.T. | EXPIRED | 2017-08-02 | 2022-12-31 | No data | 7005 NIGHTWALKER ROAD, BROOKSVILLE, FL, 34613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2025-01-15 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L25000023148. CONVERSION NUMBER 700000263767 |
| REINSTATEMENT | 2024-10-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-10-22 | SIDDIQI, FARHAN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-21 | 2040 SHORT AVE., SUITE 100, ODESSA, FL 33556 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| REINSTATEMENT | 2024-10-22 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-04-09 |
| ANNUAL REPORT | 2020-03-16 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-01-14 |
| AMENDED ANNUAL REPORT | 2017-11-14 |
| ANNUAL REPORT | 2017-03-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
