FORM 1023-EZ for TAMPA BAY MUSLIM PHYSICIANS ASSOCIATION INC

Field Data
EIN 81-5115949
Case Number EO-2017030-000402
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TAMPA BAY MUSLIM PHYSICIANS ASSOCIATION INC
Organization’s Mailing Address 500 VONDERBURG DRIVE SUITE 513
City BRANDON
State FL
ZIP 33511
Accounting period End 12
Primary contact name BRUCE KADOURA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HUSAIN NAGAMIA MD
PRESIDENT
500 VONDERBURG DRIVE SUITE 513
BRANDON FL 33511

Officer/Director/Trustee Two

NADIM KHAN MD
VP
14320 BRUCE B DOWNS
TAMPA FL 33613

Officer/Director/Trustee Three

TALAL HAMDAN MD
SECRETARY/TREASURER
17 DAVIS BLVD SUITE 313
TAMPA FL 33606

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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