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  5. AMERICAN MEDICINE, INC.

AMERICAN MEDICINE, INC.

Company Details

Entity Name: AMERICAN MEDICINE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 30 May 1996 (29 years ago)
Document Number: P96000047599
FEI/EIN Number 650699469
Address: 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL, 33324
Mail Address: 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL, 33324
ZIP code: 33324
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1437349339 2007-07-26 2007-07-26 817 S UNIVERSITY DR, SUITE 106, PLANTATION, FL, 333243309, US 817 S UNIVERSITY DR, SUITE 106, PLANTATION, FL, 333243309, US

Contacts
Phone +1 954-723-0334
Fax 9547230807

Authorized person
Name DR. SHAHNAZ FATTEH
Role VICE PRESIDENT
Phone 9547230334

Taxonomy
Taxonomy Code 207K00000X - Allergy & Immunology Physician
License Number ME63504
State FL
Is Primary Yes
Taxonomy Code 2080P0201X - Pediatric Allergy/Immunology Physician
License Number ME63504
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMERICAN MEDICINE, INC. 401(K) PLAN 2020 650699469 2021-10-13 AMERICAN MEDICINE, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9546822415
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing FAIZ FATTEH
Valid signature Filed with authorized/valid electronic signature
AMERICAN MEDICINE, INC. CASH BALANCE PLAN 2020 650699469 2021-10-13 AMERICAN MEDICINE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9546822415
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing FAIZ FATTEH
Valid signature Filed with authorized/valid electronic signature
AMERICAN MEDICINE, INC. 401(K) PLAN 2019 650699469 2020-10-13 AMERICAN MEDICINE, INC. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9546822415
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324
AMERICAN MEDICINE, INC. CASH BALANCE PLAN 2019 650699469 2021-10-13 AMERICAN MEDICINE, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9546822415
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing FAIZ FATTEH
Valid signature Filed with authorized/valid electronic signature
AMERICAN MEDICINE, INC. CASH BALANCE PLAN 2019 650699469 2020-10-14 AMERICAN MEDICINE, INC. 16
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9546822415
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324
AMERICAN MEDICINE INC. 401(K) PLAN 2018 650699469 2019-10-08 AMERICAN MEDICINE, INC. 13
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9547230334
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324
AMERICAN MEDICINE INC. 401(K) PLAN 2018 650699469 2019-10-08 AMERICAN MEDICINE, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9547230334
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324
AMERICAN MEDICINE INC. CASH BALANCE PLAN 2018 650699469 2019-10-12 AMERICAN MEDICINE, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9547230334
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324
AMERICAN MEDICINE INC. 401(K) PLAN 2017 650699469 2018-09-27 AMERICAN MEDICINE INC. 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9547230334
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324
AMERICAN MEDICINE INC. CASH BALANCE PLAN 2017 650699469 2018-10-05 AMERICAN MEDICINE INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 9547230334
Plan sponsor’s address 400 FAN PALM WAY, PLANTATION, FL, 33324

Agent

Name Role Address
FATTEH FAIZ M Agent 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL, 33324

Chief Executive Officer

Name Role Address
FATTEH FAIZ M Chief Executive Officer 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL, 33324

Vice President

Name Role Address
FATTEH SHAHNAZ Vice President 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL, 33324

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2005-01-17 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL 33324 No data
CHANGE OF MAILING ADDRESS 2005-01-17 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL 33324 No data
REGISTERED AGENT ADDRESS CHANGED 2005-01-17 817 S. UNIVERSITY DRIVE, #106, PLANTATION, FL 33324 No data

Documents

Name Date
ANNUAL REPORT 2024-02-08
ANNUAL REPORT 2023-03-23
ANNUAL REPORT 2022-04-05
ANNUAL REPORT 2021-03-05
ANNUAL REPORT 2020-06-10
ANNUAL REPORT 2019-04-10
ANNUAL REPORT 2018-04-08
ANNUAL REPORT 2017-03-21
ANNUAL REPORT 2016-03-28
ANNUAL REPORT 2015-02-23

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7198547707 2020-05-01 0455 PPP 817 UNIVERSITY DRIVE 106, PLANTATION, FL, 33324
Loan Status Date 2021-12-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 77100
Loan Approval Amount (current) 77100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 49274
Servicing Lender Name Citibank, N.A.
Servicing Lender Address 5800 S. Corporate Place, Sioux Falls, SD, 57108
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PLANTATION, BROWARD, FL, 33324-0001
Project Congressional District FL-25
Number of Employees 10
NAICS code 621999
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Subchapter S Corporation
Originating Lender ID 49274
Originating Lender Name Citibank, N.A.
Originating Lender Address Sioux Falls, SD
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 78157.14
Forgiveness Paid Date 2021-11-08

Related by officers

FATTEH FAIZ M

207 ATRIA AT PEMBROKE PINES, LLC

FATTEH SHAHNAZ

INDIAN PHYSICIANS OF SOUTH FLORIDA, INC.

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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