| Entity Name: | AMANA MEDICAL CENTER, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Mar 2012 (13 years ago) |
| Document Number: | P12000025577 |
| FEI/EIN Number | 45-4800075 |
| Address: | 220 ALAFAYA WOODS BLVD., SUITE 1000, OVIEDO, FL 32765 |
| Mail Address: | 220 ALAFAYA WOODS BLVD., SUITE 1000, OVIEDO, FL 32765 |
| ZIP code: | 32765 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891051249 | 2012-04-10 | 2018-08-25 | 220 ALAFAYA WOODS BLVD, 1000, OVIEDO, FL, 327657092, US | 220 ALAFAYA WOODS BLVD, 1000, OVIEDO, FL, 32765, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-542-7335 |
| Fax | 4075427338 |
Authorized person
| Name | DR. JAMAL A ABUSUWA |
| Role | PRESIDENT |
| Phone | 4075427335 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME87949 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | ME87949 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | ME87949 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 0033B |
| State | FL |
| Issuer | MEDICARE GROUP PROVIDER NO |
| Number | GF041A |
| State | FL |
| Issuer | MEDICAID |
| Number | 023370100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ABUSUWA, JAMAL A | Agent | 220 ALAFAYA WOODS BLVD., SUITE 1000, OVIEDO, FL 32765-6212 |
| Name | Role | Address |
|---|---|---|
| ABUSUWA, JAMAL A | Director | 220 ALAFAYA WOODS BLVD., SUITE 1000 OVIEDO, FL 32765-6212 |
| Name | Role | Address |
|---|---|---|
| ABUSUWA, JAMAL A | President | 220 ALAFAYA WOODS BLVD., SUITE 1000 OVIEDO, FL 32765-6212 |
| Name | Role | Address |
|---|---|---|
| ABUSUWA, JAMAL A | Secretary | 220 ALAFAYA WOODS BLVD., SUITE 1000 OVIEDO, FL 32765-6212 |
| Name | Role | Address |
|---|---|---|
| ABUSUWA, JAMAL A | Treasurer | 220 ALAFAYA WOODS BLVD., SUITE 1000 OVIEDO, FL 32765-6212 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2013-02-14 | 220 ALAFAYA WOODS BLVD., SUITE 1000, OVIEDO, FL 32765-6212 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-01-28 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-03-09 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-03-22 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-02-21 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
