Detail by Officer/Registered Agent Name

Foreign Not For Profit Corporation

AMERICAN COLLEGE OF PHYSICIAN EXECUTIVES, INC.

Filing Information
856996 54-1032555 07/01/1983 VA INACTIVE REVOKED FOR ANNUAL REPORT 09/22/2017 NONE
Principal Address
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Changed: 04/30/2008
Mailing Address
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Changed: 04/30/2008
Registered Agent Name & Address ANGOOD, PETER B, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Name Changed: 01/29/2013

Address Changed: 04/30/2008
Officer/Director Detail Name & Address

Title Past Chair

WERNER, MARK J, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title President, CEO

ANGOOD, PETER B, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Chairman

ASMAR, HODA, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

SMITH, JACK, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Casperson, William, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Knight, Napoleon, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

SLONIM, ANTHONY, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

LACE, DANIEL, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

POLK, JAMES, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

MARCO, ALAN, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Clapper, Laura, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Burton, Bret, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Jolissaint, Greg, MD
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Secretary

Zetterstrom, Hans
400 N Ashely Drive
Suite 400
Tampa, FL 33602

Title Treasurer

Martin, Michelle A
400 N. Ashley Drive
Suite 400
Tampa, FL 33602

Title Director

Lester, Mark, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Shaw, Howard, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Title Director

Tzeel, Albert, Dr.
400 NORTH ASHLEY DRIVE
SUITE 400
TAMPA, FL 33602

Annual Reports
Report YearFiled Date
2014 02/01/2014
2015 04/28/2015
2016 05/24/2016