| Entity Name: | PREMIER MED, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Jan 2019 (6 years ago) |
| Document Number: | P19000007544 |
| FEI/EIN Number | 83-3345207 |
| Address: | 7512 DR. PHILLIPS BLVD,, SUITE 50-344, ORLANDO, FL, 32819, US |
| Mail Address: | 7512 DR. PHILLIPS BLVD,, SUITE 50-344, ORLANDO, FL, 32819, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053877506 | 2019-02-20 | 2019-10-18 | 7512 DR PHILLIPS BLVD STE 50-344, ORLANDO, FL, 328195420, US | 2906 17TH ST., ST CLOUD, FL, 34769, US | |||||||||||||||||
|
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| Phone | +1 407-543-6306 |
Authorized person
| Name | JAUVID BEHRAM AYADI |
| Role | OWNER |
| Phone | 4073522542 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| AYADI JAUVID | Agent | 9240 SOUTHERN BREEZE DRIVE, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| AYADI JAUVID | Chief Executive Officer | 7512 Dr. Phillips Blvd, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| KALAN PRAKASH | Manager | 7512 DR. PHILLIPS BLVD,, ORLANDO, FL, 32819 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-14 | 7512 DR. PHILLIPS BLVD,, SUITE 50-344, ORLANDO, FL 32819 | No data |
| CHANGE OF MAILING ADDRESS | 2019-03-14 | 7512 DR. PHILLIPS BLVD,, SUITE 50-344, ORLANDO, FL 32819 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-03-05 |
| ANNUAL REPORT | 2022-04-16 |
| ANNUAL REPORT | 2021-03-25 |
| ANNUAL REPORT | 2020-03-25 |
| Domestic Profit | 2019-01-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
