| Entity Name: | ORLANDO PHYSICIANS GROUP INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Mar 2017 (8 years ago) |
| Document Number: | P17000023563 |
| FEI/EIN Number | 82-0853116 |
| Address: | 5385 CONROY ROAD, ORLANDO, FL, 32811, US |
| Mail Address: | 5385 CONROY ROAD, ORLANDO, FL, 32811, US |
| ZIP code: | 32811 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285169177 | 2017-04-27 | 2024-10-08 | 5385 CONROY RD STE 100&104, ORLANDO, FL, 328113719, US | 5385 CONROY RD, SUITE 100, ORLANDO, FL, 328113719, US | |||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 407-777-8794 |
| Fax | 6892081222 |
Authorized person
| Name | SHREYA N PATEL |
| Role | PRESIDENT |
| Phone | 8143803443 |
Taxonomy
| Taxonomy Code | 207K00000X - Allergy & Immunology Physician |
| License Number | ME128383 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME128383 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME132161 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| License Number | ME132161 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1386078814 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL SHREYA MD | Agent | 13908 Peach Orchard Way, Winter Garden, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| PATEL NALIN | President | 13908 Peach Orchard Way, Winter Garden, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| PATEL REKHA | Vice President | 13908 Peach Orchard Way, Winter Garden, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| PATEL SHREYA | Secretary | 13908 Peach Orchard Way, Winter Garden, FL, 34787 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000046419 | ALLERGY & ASTHMA CENTER OF ORLANDO | ACTIVE | 2017-04-27 | 2027-12-31 | No data | 5385 CONROY RD, SUITE 104, ORLANDO, FL, 32811 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2021-01-27 | 5385 CONROY ROAD, SUITE 104 and 100, ORLANDO, FL 32811 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-01-27 | PATEL, SHREYA, MD | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-14 | 5385 CONROY ROAD, SUITE 104 and 100, ORLANDO, FL 32811 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-14 | 13908 Peach Orchard Way, Winter Garden, FL 34787 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-05 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-01-27 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-14 |
| Domestic Profit | 2017-03-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
