| Entity Name: | INTEGRA NEURO PAIN INSTITUTE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
INTEGRA NEURO PAIN INSTITUTE PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 15 Nov 2018 (6 years ago) |
| Document Number: | P18000094508 |
| FEI/EIN Number |
83-2582180
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 8297 CHAMPIONS GATE BLVD, 463, CHAMPIONS GATE, FL, 33896, FL |
| Mail Address: | 8297 CHAMPIONS GATE BLVD, 463, CHAMPIONS GATE, FL, 33896, FL |
| ZIP code: | 33896 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881158939 | 2019-01-23 | 2023-04-17 | 8297 CHAMPIONS GATE BLVD STE 463, CHAMPIONS GATE, FL, 338968387, US | 5979 VINELAND RD STE 114, ORLANDO, FL, 328197855, US | |||||||||||||||||||||||||
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| Phone | +1 863-547-0788 |
| Fax | 8635470789 |
Authorized person
| Name | DR. MOHAMMAD MASOOM QURESHI |
| Role | PRESIDENT/PHYSICIAN |
| Phone | 8635470788 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P2900X - Pain Medicine (Psychiatry & Neurology) Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021662900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| QURESHI MOHAMMAD | President | 8297 CHAMPIONS GATE BLVD #463, CHAMPIONS GATE, FL, 33896 |
| AWAN AMAL | Vice President | 8297 CHAMPIONS GATE BLVD, CHAMPIONS GATE, FL, 33896 |
| Mayes Tonya | Prac | 8297 CHAMPIONS GATE BLVD, CHAMPIONS GATE, FL, 33896 |
| QURESHI MOHAMMAD | Agent | 8297 CHAMPIONS GATE BLVD, CHAMPIONS GATE, FL, 33896 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-02 |
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-02-21 |
| AMENDED ANNUAL REPORT | 2021-05-05 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-05-01 |
| Domestic Profit | 2018-11-15 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2654177400 | 2020-05-06 | 0455 | PPP | 2217 North Blvd W Ste B, Davenport, FL, 33837 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
