| Entity Name: | JOHN FARAH, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 28 Mar 2022 (3 years ago) |
| Document Number: | P22000027246 |
| FEI/EIN Number | 88-1490471 |
| Address: | 55 North Carpenter Rd., Titusville, FL 32796 |
| Mail Address: | 55 North Carpenter Rd., Titusville, FL 32796 |
| ZIP code: | 32796 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366188922 | 2022-05-06 | 2022-05-06 | 55 N CARPENTER RD, TITUSVILLE, FL, 327962204, US | 55 N CARPENTER RD, TITUSVILLE, FL, 327962204, US | |||||||||||||||||||||
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| Phone | +1 321-269-3802 |
| Fax | 3212690920 |
Authorized person
| Name | DR. JOHN E. FARAH |
| Role | DENTIST |
| Phone | 3216140486 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DENTIST PRACTICING AT LOCATION |
| Number | 1578930707 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN FARAH, PA 401(K) PLAN | 2023 | 881490471 | 2024-05-31 | JOHN FARAH, PA | 0 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-05-31 |
| Name of individual signing | JOHN FARAH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| PORTO, CURRAN K, PA | Agent | 410 S. WARE BLVD, STE. 800, TAMPA, FL 33619 |
| Name | Role | Address |
|---|---|---|
| FARAH, JOHN | President | 55 NORTH CARPENTER RD., TITUSVILLE, FL 32796 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000158201 | FARAH DENTISTRY | ACTIVE | 2022-12-21 | 2027-12-31 | No data | 55 NORTH CARPENTER RD., TITUSVILLE, FL, 32796 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-10-03 | 55 North Carpenter Rd., Titusville, FL 32796 | No data |
| CHANGE OF MAILING ADDRESS | 2022-10-03 | 55 North Carpenter Rd., Titusville, FL 32796 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-03-11 |
| Domestic Profit | 2022-03-28 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
