| Entity Name: | CENTRAL FLORIDA MEDICAL ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Aug 1999 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2008 (16 years ago) |
| Document Number: | P99000073846 |
| FEI/EIN Number | 593590423 |
| Mail Address: | 235 CADDIE COURT, DEBARY, FL, 32713 |
| Address: | 2555 SOUTH VOLUSIA AVENUE, ORANGE CITY, FL, 32763, US |
| ZIP code: | 32763 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528111085 | 2007-01-19 | 2015-01-12 | 2555 S VOLUSIA AVE, ORANGE CITY, FL, 327639135, US | 2555 S VOLUSIA AVE, ORANGE CITY, FL, 327639135, US | |||||||||||||||||||||||||
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| Phone | +1 386-774-0401 |
| Fax | 3867745783 |
Authorized person
| Name | MRS. ILENE BALLENTINE |
| Role | OFFICE MANAGER |
| Phone | 3867740401 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME75141 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | K2371 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AHMED SYED-BILAL Dr. | Agent | 235 CADDIE COURT, DEBARY, FL, 32713 |
| Name | Role | Address |
|---|---|---|
| AHMED SHAZIA Dr. | President | 235 CADDIE COURT, DEBARY, FL, 32713 |
| Name | Role | Address |
|---|---|---|
| AHMED SYED-BILAL Dr. | Manager | 235 CADDIE COURT, DEBARY, FL, 32713 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-17 | 2555 SOUTH VOLUSIA AVENUE, ORANGE CITY, FL 32763 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-03-17 | AHMED, SYED-BILAL, Dr. | No data |
| REINSTATEMENT | 2008-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2000-04-29 | 2555 SOUTH VOLUSIA AVENUE, ORANGE CITY, FL 32763 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2000-04-29 | 235 CADDIE COURT, DEBARY, FL 32713 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-09-14 |
| ANNUAL REPORT | 2021-09-16 |
| ANNUAL REPORT | 2020-07-15 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-03-23 |
| ANNUAL REPORT | 2017-08-31 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-03-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
