| Entity Name: | M. EMDADUL HAQUE, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 26 May 1999 (26 years ago) |
| Document Number: | P99000049345 |
| FEI/EIN Number | 593588014 |
| Address: | 6069 SABAL HAMMOCK CIR, PORT ORANGE, FL, 32128 |
| Mail Address: | 6069 SABAL HAMMOCK CIR, PORT ORANGE, FL, 32128 |
| ZIP code: | 32128 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073773214 | 2008-06-11 | 2008-06-11 | 412 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687361, US | 412 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687361, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 386-427-4752 |
Authorized person
| Name | DR. M. EMDADUL HAQUE |
| Role | OWNER |
| Phone | 3864274752 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME0076036 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HAQUE M. EMDADUL | Agent | 6069 SABAL HAMMOCK CIR, PORT ORANGE, FL, 32128 |
| Name | Role | Address |
|---|---|---|
| HAQUE M. EMDADUL | Director | 6069 SABAL HAMMOCK CIRCLE, PORT ORANGE, FL, 32128 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2002-01-28 | 6069 SABAL HAMMOCK CIR, PORT ORANGE, FL 32128 | No data |
| CHANGE OF MAILING ADDRESS | 2002-01-28 | 6069 SABAL HAMMOCK CIR, PORT ORANGE, FL 32128 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-01-28 | 6069 SABAL HAMMOCK CIR, PORT ORANGE, FL 32128 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-07 |
| ANNUAL REPORT | 2022-01-04 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-01-07 |
| ANNUAL REPORT | 2019-01-30 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-05-12 |
| ANNUAL REPORT | 2016-02-09 |
| ANNUAL REPORT | 2015-03-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
