| Entity Name: | PORT ORANGE INTERNISTS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Feb 1995 (30 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: | 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 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PORT ORANGE INTERNISTS, P.A. DEFINED BENEFIT PLAN | 2013 | 593292082 | 2014-10-15 | PORT ORANGE INTERNISTS, P.A. | 3 | |||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2014-10-15 |
| Name of individual signing | SHAZA MOUSSLY |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-10-15 |
| Name of individual signing | SHAZA MOUSSLY |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2012-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3867564400 |
| Plan sponsor’s address | 3890 TURTLE CREEK DRIVE, SUITE C, PORT ORANGE, FL, 32127 |
Signature of
| Role | Plan administrator |
| Date | 2013-10-03 |
| Name of individual signing | SHAZA MOUSSLY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Chahwala Kinjal B | Agent | 3890 TURTLE CREEK DR., PORT ORANGE, FL, 32127 |
| Name | Role | Address |
|---|---|---|
| Chahwala Kinjal BDr. | President | 3890 TURTLE CREEK DR., PORT ORANGE, FL, 32127 |
| Name | Role | Address |
|---|---|---|
| Moise Pierre C | Vice President | 3890 TURTLE CREEK DR., PORT ORANGE, FL, 32127 |
| Name | Role | Address |
|---|---|---|
| Moise Nikenston Dr. | Treasurer | 219 Big Sky Drive, Minneola, FL, 34715 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-09 | 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL 32127 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-09 | 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL 32127 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-01-02 | Chahwala, Kinjal B | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-03-29 | 3890 TURTLE CREEK DR., SUITE C, PORT ORANGE, FL 32127 | No data |
| NAME CHANGE AMENDMENT | 2004-12-15 | PORT ORANGE INTERNISTS, P.A. | No data |
| 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 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
