| Entity Name: | PIONEER HEALTH ALLIANCE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Oct 2010 (14 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | P10000081849 |
| FEI/EIN Number | 27-3635401 |
| Mail Address: | 9927 GIFFIN COURT, WINDERMERE, FL 34786 |
| Address: | 1004 N. 14TH ST SUITE 109,, LEESBURG, FL 34748 |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497065478 | 2010-10-08 | 2016-04-13 | 1580 SANTA BARBARA BLVD, THE VILLAGES, FL, 321596827, US | 1580 SANTA BARBARA BLVD, THE VILLAGES, FL, 321596827, US | |||||||||||||||||||||||||||||
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| Phone | +1 352-508-1125 |
| Fax | 3526744386 |
Authorized person
| Name | SEEMA KHANNA |
| Role | OWNER/OPERATOR |
| Phone | 3525163972 |
Taxonomy
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010139401 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | EY818A |
| State | FL |
| Name | Role |
|---|---|
| PREMIER LAW GROUP, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| KHANNA, DINESH | President | 9927 GIFFIN COURT, WINDERMERE, FL 34786 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000131144 | PIONEER URGENT LAB | EXPIRED | 2016-12-07 | 2021-12-31 | No data | 1580 SANTA BARBARA BLVD STE B, THE VILLAGES, FL, 32162 |
| G16000119582 | PIONEER LABORATORY SERVICES OF CENTRAL FLORIDA | ACTIVE | 2016-11-03 | 2026-12-31 | No data | 1580 SANTA BARBARA BLVD STE B, THE VILLAGES, FL, 32162 |
| G13000120379 | WELLNESS ON WHEELS | EXPIRED | 2013-12-09 | 2018-12-31 | No data | 1004 N. 14TH ST SUITE 109, LEESBURG, FL, 34748 |
| G12000096974 | SUMTER MEDICAL CENTER | EXPIRED | 2012-10-03 | 2017-12-31 | No data | 1580 SANTA BARBARA BLVD STE C, THE VILLAGES, FL, 32162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-26 | PREMIER LAW GROUP, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-26 | 9927 GIFFIN COURT, WINDERMERE, FL 34786 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-26 | 1004 N. 14TH ST SUITE 109,, LEESBURG, FL 34748 | No data |
| AMENDMENT | 2018-06-27 | No data | No data |
| NAME CHANGE AMENDMENT | 2013-07-15 | PIONEER HEALTH ALLIANCE, INC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-05-07 | 1004 N. 14TH ST SUITE 109,, LEESBURG, FL 34748 | No data |
| AMENDMENT | 2010-10-27 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000469569 | TERMINATED | 1000000788860 | LAKE | 2018-07-02 | 2028-07-05 | $ 1,578.55 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, LEESBURG SERVICE CENTER, 1904 THOMAS AVE STE 103, LEESBURG FL347483289 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-02-13 |
| Amendment | 2018-06-27 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-01-07 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
