| Entity Name: | ATLANTIC VISITING PRACTICE PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Jan 2021 (4 years ago) |
| Document Number: | P21000009555 |
| FEI/EIN Number | 86-1971894 |
| Address: | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 |
| Mail Address: | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 |
| ZIP code: | 32233 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023601887 | 2021-02-12 | 2021-02-12 | 6310 BEACH BLVD, JACKSONVILLE, FL, 322162708, US | 6310 BEACH BLVD, JACKSONVILLE, FL, 322162708, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 904-551-9757 |
| Fax | 9045519701 |
Authorized person
| Name | DR. BABUR H BHATTI |
| Role | P, T |
| Phone | 7036096430 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0805X - Geriatric Psychiatry Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS FL |
| Number | WBPPL |
| State | FL |
| Issuer | BCBS FL |
| Number | 17113 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ & COMPANY, CPA, PA | Agent | 2655 S LE JEUNE ROAD, SUITE 576, CORAL GABLES, FL 33134 |
| Name | Role | Address |
|---|---|---|
| BHATTI, BABUR H | President | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 |
| Name | Role | Address |
|---|---|---|
| BHATTI, BABUR H | Treasurer | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 |
| Name | Role | Address |
|---|---|---|
| BHATTI, BABUR H | Secretary | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-26 | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-26 | 715 SEMINOLE RD, ATLANTIC BEACH, FL 32233 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-25 | 2655 S LE JEUNE ROAD, SUITE 576, CORAL GABLES, FL 33134 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-26 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-25 |
| Domestic Profit | 2021-01-22 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
