| Entity Name: | BABA PHYSICIANS GROUP, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Jun 2022 (3 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | P22000047286 |
| FEI/EIN Number | 88-2713604 |
| Address: | 948 S. WICKHAM RD., STE 101, WEST MELBOURE, FL 32904 |
| Mail Address: | 948 S. WICKHAM RD., STE 101, WEST MELBOURE, FL 32904 |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629795166 | 2022-10-25 | 2022-10-25 | 948 S WICKHAM RD STE 101, MELBOURNE, FL, 329041647, US | 948 S WICKHAM RD STE 101, MELBOURNE, FL, 329041647, US | |||||||||||||||||||||||||||
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| Phone | +1 321-956-7370 |
| Fax | 3219567873 |
Authorized person
| Name | GEETHA PRIYANKA |
| Role | CHAIRMAN/ MEDICAL DIRECTOR |
| Phone | 3219567370 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 257471300 |
| State | FL |
| Issuer | OTHER (NON-MEDICARE) |
| Number | 49252 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PRIYANKA, GEETHA | Agent | 948 S. WICKHAM RD., STE 101, WEST MELBOURNE, FL 32904 |
| Name | Role | Address |
|---|---|---|
| PRIYANKA, GEETHA | President | 948 S. WICKHAM RD. STE 101, WEST MELBOURNE, FL 32904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-28 |
| Domestic Profit | 2022-06-08 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
