| Entity Name: | EAST PASCO PULMONARY AND CRITICAL CARE ASSOCIATES INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 22 Jan 1996 (29 years ago) |
| Date of dissolution: | 22 Apr 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 22 Apr 2017 (8 years ago) |
| Document Number: | P96000007532 |
| FEI/EIN Number | 59-3356549 |
| Address: | 38152 medical center ave, zephyrhills, FL 33540 |
| Mail Address: | P O BOZ 100, SAN ANTONIO, FL 33576 |
| ZIP code: | 33540 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568472652 | 2006-08-09 | 2011-12-08 | 38152 MEDICAL CENTER AVENUE, ZEPHYRHILLS, FL, 33540, US | 38152 MEDICAL CENTER AVENUE, ZEPHYRHILLS, FL, 33540, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-782-4560 |
| Fax | 8137889202 |
Authorized person
| Name | MARLENY CHAKOLA |
| Role | VICE PRESIDENT |
| Phone | 8137824560 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME42585 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BSBC |
| Number | 51194 |
| State | FL |
| Issuer | RAILROAD PROV.# |
| Number | DC9749 |
| State | FL |
| Issuer | MEDICAID |
| Number | 003215900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHAKOLA, PAUL L | Agent | P O BOZ 100, SAN ANTONIO, FL 33576 |
| Name | Role | Address |
|---|---|---|
| PAUL L. CHAKOLA | President | P O BOZ 100, SAN ANTONIO, FL 33576 |
| Name | Role | Address |
|---|---|---|
| PAUL L. CHAKOLA | Director | P O BOZ 100, SAN ANTONIO, FL 33576 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-04-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-22 | 38152 medical center ave, zephyrhills, FL 33540 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-17 | P O BOZ 100, SAN ANTONIO, FL 33576 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-17 | 38152 medical center ave, zephyrhills, FL 33540 | No data |
| CANCEL ADM DISS/REV | 2007-12-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| REINSTATEMENT | 2003-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-04-17 |
| ANNUAL REPORT | 2014-04-18 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-26 |
| ANNUAL REPORT | 2011-04-21 |
| ANNUAL REPORT | 2010-04-04 |
| ANNUAL REPORT | 2009-04-19 |
| ANNUAL REPORT | 2008-03-04 |
| REINSTATEMENT | 2007-12-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
