| Entity Name: | TAVARES PEDIATRICS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 06 Sep 2011 (13 years ago) |
| Document Number: | P11000078488 |
| FEI/EIN Number | 45-3176145 |
| Address: | 2754 DORA AVENUE, TAVARES, FL 32778 |
| Mail Address: | 265 CITRUS TOWER BOULEVARD, #102, CLERMONT, FL 34711 |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629641923 | 2021-07-23 | 2023-12-13 | 2754 DORA AVE, TAVARES, FL, 327784970, US | 2754 DORA AVE, TAVARES, FL, 327784970, US | |||||||||||||||||||
|
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| Phone | +1 352-508-5176 |
Authorized person
| Name | MOHAMMAD AFZAL |
| Role | OWNER |
| Phone | 3523943929 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004771001 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AFZAL, MOHAMMAD DR | Agent | 265 CITRUS TOWER BOULEVARD, #102, CLERMONT, FL 34711 |
| Name | Role | Address |
|---|---|---|
| AFZAL, MOHAMMAD DR | President | 265 CITRUS TOWER BOULEVARD, #102 CLERMONT, FL 34711 |
| Name | Role | Address |
|---|---|---|
| AFZAL, NADIA | Vice President | 265 CITRUS TOWER BOULEVARD, #102 CLERMONT, FL 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-04 | 2754 DORA AVENUE, TAVARES, FL 32778 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-27 | 265 CITRUS TOWER BOULEVARD, #102, CLERMONT, FL 34711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-02-12 |
| ANNUAL REPORT | 2019-01-31 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-02-02 |
| ANNUAL REPORT | 2016-01-17 |
| ANNUAL REPORT | 2015-01-11 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
