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HAINES CITY INTERNAL MEDICINE, P.A. - Florida Company Profile

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Company Details

Entity Name: HAINES CITY INTERNAL MEDICINE, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 13 Sep 1999 (26 years ago)
Date of dissolution: 23 Sep 2022 (3 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (3 years ago)
Document Number: P99000082075
FEI/EIN Number 650951037
Address: 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
Mail Address: 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
ZIP code: 33844
City: Haines City
County: Polk
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
ALLENDE GUILLERMO President 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
ALLENDE GUILLERMO Director 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
STINE JAY C Vice President 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
STINE JAY C Secretary 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
STINE JAY C Treasurer 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
STINE JAY C Director 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844
ALLENDE GUILLERMO Agent 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844

National Provider Identifier

NPI Number:
1386799542
Certification Date:
2020-04-24

Authorized Person:

Name:
DR. JAY C STINE JR.
Role:
PART OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8634213246

Form 5500 Series

Employer Identification Number (EIN):
650951037
Plan Year:
2009
Number Of Participants:
14
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -
CHANGE OF PRINCIPAL ADDRESS 2008-02-01 608 INGRAHAM AVENUE, HAINES CITY, FL 33844 -
CHANGE OF MAILING ADDRESS 2008-02-01 608 INGRAHAM AVENUE, HAINES CITY, FL 33844 -
REGISTERED AGENT ADDRESS CHANGED 2008-02-01 608 INGRAHAM AVENUE, HAINES CITY, FL 33844 -

Documents

Name Date
ANNUAL REPORT 2021-02-01
ANNUAL REPORT 2020-03-20
ANNUAL REPORT 2019-02-15
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-01-13
ANNUAL REPORT 2014-01-13
ANNUAL REPORT 2013-01-28
ANNUAL REPORT 2012-03-22

USAspending Awards / Financial Assistance

Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
111000.00
Total Face Value Of Loan:
111000.00
Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
111000.00
Total Face Value Of Loan:
111000.00

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$111,000
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$111,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$111,635.17
Servicing Lender:
SouthState Bank, National Association
Use of Proceeds:
Payroll: $111,000

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Date of last update: 02 Aug 2025

Sources: Florida Department of State