| Entity Name: | ZAFAR HUSSAIN INTERNAL MEDICINE INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Sep 2013 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 16 May 2023 (2 years ago) |
| Document Number: | P13000078168 |
| FEI/EIN Number | 46-3704933 |
| Address: | 750 Harrison St, PANAMA CITY, FL, 32401, US |
| Mail Address: | 750 Harrison St, PANAMA CITY, FL, 32401, US |
| ZIP code: | 32401 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821403411 | 2014-06-23 | 2014-12-02 | PO BOX 15548, PANAMA CITY, FL, 324065548, US | 1714 W 23RD ST STE P, PANAMA CITY, FL, 324052924, US | |||||||||||||||||||
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| Phone | +1 850-481-1032 |
| Fax | 8504811437 |
Authorized person
| Name | DR. ZAFAR HUSSAIN |
| Role | OWNER |
| Phone | 8502576668 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME103366 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ZAFAR HUSSAIN INTERNAL MEDICINE, INC. 401(K) PLAN | 2020 | 463704933 | 2021-03-31 | ZAFAR HUSSAIN INTERNAL MEDICINE, INC. | 3 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-03-31 |
| Name of individual signing | ZAFAR HUSSAIN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8502576668 |
| Plan sponsor’s address | 204 TIMBER LANE, PANAMA CITY, FL, 32405 |
Signature of
| Role | Plan administrator |
| Date | 2020-10-14 |
| Name of individual signing | ZAFAR HUSSAIN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8502576668 |
| Plan sponsor’s address | 204 TIMBER LANE, PANAMA CITY, FL, 32405 |
Signature of
| Role | Plan administrator |
| Date | 2019-07-17 |
| Name of individual signing | ZAFAR HUSSAIN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8502576668 |
| Plan sponsor’s address | 204 TIMBER LANE, PANAMA CITY, FL, 32405 |
Signature of
| Role | Plan administrator |
| Date | 2018-07-26 |
| Name of individual signing | ZAFAR HUSSAIN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Zafar Hussain | Agent | 750 Harrison St, PANAMA CITY, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| WAHEED ATIKA | Vice President | 204 TIMBER LANE, PANAMA CITY, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| HUSSAIN ZAFAR | President | 204 TIMBER LANE, PANAMA CITY, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| Zafar Abdul R | Director | P.O. BOX 15548, PANAMA CITY, FL, 32406 |
| Zafar Wardah | Director | P.O. BOX 15548, PANAMA CITY, FL, 32406 |
| Zafar Baheerah | Director | P.O. BOX 15548, PANAMA CITY, FL, 32406 |
| Zafar Abdul-Hanna | Director | P.O. BOX 15548, PANAMA CITY, FL, 32406 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000089733 | PRIMARY CARE CLINIC | EXPIRED | 2014-09-02 | 2019-12-31 | No data | P.O.BOX 15548, PANAMA CITY, FL, 32406 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-05-16 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2023-05-16 | 750 Harrison St, PANAMA CITY, FL 32401 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-05-16 | Zafar, Hussain | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-16 | 750 Harrison St, PANAMA CITY, FL 32401 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-05-01 | 750 Harrison St, PANAMA CITY, FL 32401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| REINSTATEMENT | 2023-05-16 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-04-22 |
| ANNUAL REPORT | 2014-04-30 |
| Domestic Profit | 2013-09-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
