| Entity Name: | CHANNAN,MD,PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 19 May 2021 (4 years ago) |
| Document Number: | P21000048863 |
| FEI/EIN Number | 87-0974306 |
| Address: | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| Mail Address: | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| ZIP code: | 33431 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699344663 | 2021-06-23 | 2021-06-23 | 660 GLADES RD STE 140, BOCA RATON, FL, 334316466, US | 660 GLADES RD STE 140, BOCA RATON, FL, 334316466, US | |||||||||||||||
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| Phone | +1 561-447-7737 |
| Fax | 5614479022 |
Authorized person
| Name | GITANJLI CHANNAN |
| Role | OWNER/PHYSICIAN |
| Phone | 5133167639 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHANNAN MD PA 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 870974306 | 2024-07-25 | CHANNAN MD PA | 6 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-25 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 5133167639 |
| Plan sponsor’s address | 660 GLADES RD STE 140, BOCA RATON, FL, 33431 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-26 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 812990 |
| Sponsor’s telephone number | 5133167639 |
| Plan sponsor’s address | 660 GLADES RD STE 140, BOCA RATON, FL, 33431 |
Signature of
| Role | Plan administrator |
| Date | 2022-05-19 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CHANNAN, GITANJLI, M.D. | Agent | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| CHANNAN, GITANJLI, M.D. | President | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| CHANNAN, GITANJLI, M.D. | Treasurer | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| CHANNAN, GITANJLI, M.D. | Director | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| Name | Role | Address |
|---|---|---|
| CHANNAN, GITANJLI, M.D. | Secretary | 660 GLADES ROAD SUITE 140, BOCA RATON, FL 33431 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-10 |
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-03-05 |
| ANNUAL REPORT | 2022-02-27 |
| Domestic Profit | 2021-05-19 |
Date of last update: 13 Feb 2025
Sources: Florida Department of State
