| Entity Name: | DELAND PEDIATRIC ASSOCIATES, M.D.P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Sep 1998 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 31 Oct 2022 (2 years ago) |
| Document Number: | P98000081855 |
| FEI/EIN Number | 593537489 |
| Address: | 999 N. STONE STREET, SUITE A, DELAND, FL, 32720 |
| Mail Address: | 999 N. STONE STREET, SUITE A, DELAND, FL, 32720 |
| ZIP code: | 32720 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194801571 | 2006-10-28 | 2012-01-10 | 999 N STONE ST, SUITE A, DELAND, FL, 327200800, US | 999 N STONE ST, SUITE A, DELAND, FL, 327200800, US | |||||||||||||||||||||||
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| Phone | +1 386-738-6804 |
| Fax | 3869434046 |
Authorized person
| Name | DR. BHAVNABEN B PATEL |
| Role | PRESIDENT |
| Phone | 3867386804 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 255187000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL BHAVNABEN B | Agent | 999 N. STONE STREET, DELAND, FL, 32720 |
| Name | Role | Address |
|---|---|---|
| PATEL BHAVNABEN B | Manager | 999 N. STONE STREET #A, DELAND, FL, 32720 |
| Name | Role | Address |
|---|---|---|
| PATEL BHAVNABEN B | Director | 999 N. STONE STREET #A, DELAND, FL, 32720 |
| PATEL USHA P | Director | 999 N. STONE STREET #A, DELAND, FL, 32720 |
| Name | Role | Address |
|---|---|---|
| PATEL USHA P | Secretary | 999 N. STONE STREET #A, DELAND, FL, 32720 |
| Name | Role | Address |
|---|---|---|
| PATEL USHA P | Treasurer | 999 N. STONE STREET #A, DELAND, FL, 32720 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-10-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-11-07 | PATEL, BHAVNABEN B | No data |
| REINSTATEMENT | 2018-11-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-07 | 999 N. STONE STREET, SUITE A, DELAND, FL 32720 | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-07 | 999 N. STONE STREET, SUITE A, DELAND, FL 32720 | No data |
| CANCEL ADM DISS/REV | 2005-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-04-01 |
| REINSTATEMENT | 2022-10-31 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-02-26 |
| ANNUAL REPORT | 2019-02-13 |
| REINSTATEMENT | 2018-11-07 |
| ANNUAL REPORT | 2016-02-02 |
| ANNUAL REPORT | 2015-02-26 |
| ANNUAL REPORT | 2014-01-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
