| Entity Name: | PRIMARY CARE OF ORLANDO, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Aug 1998 (27 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 May 2001 (24 years ago) |
| Document Number: | P98000069463 |
| FEI/EIN Number | 593526432 |
| Address: | 5308 S. JOHN YOUNG PKWY, #100, ORLANDO, FL, 32839 |
| Mail Address: | 5308 S. JOHN YOUNG PKWY, #100, ORLANDO, FL, 32839 |
| ZIP code: | 32839 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932221504 | 2007-04-04 | 2012-11-07 | 5308 S JOHN YOUNG PKWY, SUITE 100, ORLANDO, FL, 328397362, US | 5308 S JOHN YOUNG PKWY, SUITE 100, ORLANDO, FL, 328397362, US | |||||||||||||||||||||||||
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| Phone | +1 407-857-2144 |
| Fax | 4078579366 |
Authorized person
| Name | JASEEM A KHAN |
| Role | PRESIDENT |
| Phone | 4078572144 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME71184 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 250895800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KHAN JASEEM A | Agent | 5308 S. JOHN YOUNG PKWY, #100, ORLANDO, FL, 32839 |
| Name | Role | Address |
|---|---|---|
| KHAN JASEEM | President | 11048 ULLSWATER LN, WINDERMERE, FL, 34786 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2006-02-02 | 5308 S. JOHN YOUNG PKWY, #100, ORLANDO, FL 32839 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-02-02 | 5308 S. JOHN YOUNG PKWY, #100, ORLANDO, FL 32839 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-04-11 | 5308 S. JOHN YOUNG PKWY, #100, ORLANDO, FL 32839 | No data |
| REINSTATEMENT | 2001-05-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2001-05-07 | KHAN, JASEEM A | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-02-24 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-03-03 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-03-02 |
| ANNUAL REPORT | 2018-02-04 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-03-15 |
| ANNUAL REPORT | 2015-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
