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PORT ORANGE INTERNISTS, P.A. - Florida Company Profile

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Company Details

Entity Name: PORT ORANGE INTERNISTS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 02 Feb 1995 (31 years ago)
Date of dissolution: 27 Sep 2024 (a year ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (a year ago)
Document Number: P95000009128
FEI/EIN Number 593292082
Mail Address: PO Box 1635, Minneola, FL, 34755, US
Address: 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL, 32127, US
ZIP code: 32127
City: Port Orange
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Chahwala Kinjal BDr. President 3890 TURTLE CREEK DR., PORT ORANGE, FL, 32127
Moise Pierre C Vice President 3890 TURTLE CREEK DR., PORT ORANGE, FL, 32127
Chahwala Kinjal B Agent 3890 TURTLE CREEK DR., PORT ORANGE, FL, 32127
Moise Nikenston Dr. Treasurer 219 Big Sky Drive, Minneola, FL, 34715

National Provider Identifier

NPI Number:
1689861205

Authorized Person:

Name:
SOUHEIL MOUSSLY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
593292082
Plan Year:
2017
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
3
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 - -
CHANGE OF MAILING ADDRESS 2023-03-09 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL 32127 -
REGISTERED AGENT ADDRESS CHANGED 2023-03-09 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL 32127 -
REGISTERED AGENT NAME CHANGED 2018-01-02 Chahwala, Kinjal B -
CHANGE OF PRINCIPAL ADDRESS 2010-03-29 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL 32127 -
NAME CHANGE AMENDMENT 2004-12-15 PORT ORANGE INTERNISTS, P.A. -

Documents

Name Date
ANNUAL REPORT 2023-03-09
ANNUAL REPORT 2022-02-02
ANNUAL REPORT 2021-01-29
ANNUAL REPORT 2020-03-13
ANNUAL REPORT 2019-04-24
ANNUAL REPORT 2018-01-02
ANNUAL REPORT 2017-01-12
ANNUAL REPORT 2016-01-29
ANNUAL REPORT 2015-03-06
ANNUAL REPORT 2014-01-13

USAspending Awards / Financial Assistance

Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
15584.00
Total Face Value Of Loan:
15584.00
Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
15584.00
Total Face Value Of Loan:
15584.00

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$15,584
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$15,584
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$15,758.63
Servicing Lender:
Bank of America, National Association
Use of Proceeds:
Payroll: $15,584

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Date of last update: 03 Aug 2025

Sources: Florida Department of State