Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Hillsborough
    4. ›
  4. 33614
    5. ›
  5. JOSE A. QUIMBAYO, M.D., P.A.

JOSE A. QUIMBAYO, M.D., P.A.

Company Details

Entity Name: JOSE A. QUIMBAYO, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 09 Jan 1998 (27 years ago)
Date of dissolution: 15 Mar 2017 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 15 Mar 2017 (8 years ago)
Document Number: P98000002536
FEI/EIN Number 593486610
Address: 3201W WATERS AVE, A, TAMPA, FL, 33614
Mail Address: 11508 Trotting Down Dr, Odessa, FL, 33556, US
ZIP code: 33614
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1902936024 2007-03-07 2007-07-25 3201 W WATERS AVE SUITE A, TAMPA, FL, 33614, US 3201 W WATERS AVE STE A, TAMPA, FL, 336142879, US

Contacts
Phone +1 813-915-0055
Fax 8139311552

Authorized person
Name DR. JOSE ALFONSO QUIMBAYO
Role PRESIDENT
Phone 8139150055

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number ME0063746
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOSE A. QUIMBAYO, M.D., P.A. 401(K) PLAN 2015 593486610 2016-07-25 JOSE A. QUIMBAYO, M.D., P.A. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-05-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055
JOSE A. QUIMBAYO, M.D., P.A. 401(K) PLAN 2014 593486610 2016-06-28 JOSE A. QUIMBAYO, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-05-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055
JOSE QUIMBAYO, M.D., P.A. PENSION PLAN 2014 593486610 2015-09-23 JOSE A. QUIMBAYO, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2015-09-23
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE QUIMBAYO, M.D., P.A. PENSION PLAN 2013 593486610 2014-09-16 JOSE A. QUIMBAYO, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2014-09-16
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE QUIMBAYO, M.D., P.A. PENSION PLAN 2012 593486610 2013-10-04 JOSE A. QUIMBAYO, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2013-10-04
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE QUIMBAYO, M.D., P.A. PENSION PLAN 2011 593486610 2012-10-15 JOSE A. QUIMBAYO, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE QUIMBAYO, M.D., P.A. PENSION PLAN 2010 593486610 2011-10-14 JOSE A. QUIMBAYO, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE A. QUIMBAYO, M.D., P.A. 401(K) PLAN 2010 593486610 2012-09-04 JOSE A. QUIMBAYO, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-05-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2012-09-04
Name of individual signing CLARA QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE A. QUIMBAYO, M.D., P.A. 401(K) PLAN 2009 593486610 2010-09-30 JOSE A. QUIMBAYO, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-05-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2010-09-30
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature
JOSE QUIMBAYO, M.D., P.A. PENSION PLAN 2009 593486610 2010-09-30 JOSE A. QUIMBAYO, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8139150055
Plan sponsor’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614

Plan administrator’s name and address
Administrator’s EIN 593486610
Plan administrator’s name JOSE A. QUIMBAYO, M.D., P.A.
Plan administrator’s address 3201 W. WATERS AVENUE, SUITE A, TAMPA, FL, 33614
Administrator’s telephone number 8139150055

Signature of
Role Plan administrator
Date 2010-09-30
Name of individual signing JOSE A. QUIMBAYO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
QUIMBAYO CLARA E Agent 3201 W. WATER AVE., #A, TAMPA, FL, 33624

President

Name Role Address
QUIMBAYO JOSE AMD President 11508 TROTTING DOWN DR, ODESSA, FL, 33556

Director

Name Role Address
QUIMBAYO JOSE AMD Director 11508 TROTTING DOWN DR, ODESSA, FL, 33556

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2017-03-15 No data No data
CHANGE OF MAILING ADDRESS 2016-06-07 3201W WATERS AVE, A, TAMPA, FL 33614 No data
REGISTERED AGENT NAME CHANGED 2013-04-03 QUIMBAYO, CLARA E No data
REINSTATEMENT 2004-10-20 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2004-10-01 No data No data
REGISTERED AGENT ADDRESS CHANGED 2003-01-17 3201 W. WATER AVE., #A, TAMPA, FL 33624 No data
REINSTATEMENT 2002-11-05 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2002-10-04 No data No data
CHANGE OF PRINCIPAL ADDRESS 2000-02-24 3201W WATERS AVE, A, TAMPA, FL 33614 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2017-03-15
ANNUAL REPORT 2016-06-07
ANNUAL REPORT 2015-04-07
ANNUAL REPORT 2014-01-14
ANNUAL REPORT 2013-04-03
ANNUAL REPORT 2012-05-01
ANNUAL REPORT 2011-02-18
ANNUAL REPORT 2010-01-28
ANNUAL REPORT 2009-05-18
ANNUAL REPORT 2008-06-18

Related by officers

QUIMBAYO CLARA E

CACHIPAY, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated