| Entity Name: | ASHOK ROYCHOUDHURY, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Jan 1981 (44 years ago) |
| Document Number: | F14206 |
| FEI/EIN Number | 592059789 |
| Address: | 2032-A SOUTHSIDE BLVD, JACKSONVILLE, FL, 32216 |
| Mail Address: | 2032-A SOUTHSIDE BLVD, JACKSONVILLE, FL, 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992015812 | 2010-10-13 | 2010-10-26 | 2032A SOUTHSIDE BLVD, JACKSONVILLE, FL, 322161944, US | 2032A SOUTHSIDE BLVD, JACKSONVILLE, FL, 322161944, US | |||||||||||||||||||||||||
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| Phone | +1 904-724-0300 |
| Fax | 9047201943 |
Authorized person
| Name | ASHOK ROYCHOUDHURY |
| Role | PRESIDENT OF CORPORATION |
| Phone | 9047240300 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME0033384 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 037707400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROYCHOUDHURY, ASHOK, M.D. | Agent | 2032A SOUTHSIDE BLVD., JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| ROYCHOUDHURY, ASHOK, MD. | President | 2032-A SOUTHSIDE BLVD, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REINSTATEMENT | 1985-12-16 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1984-11-21 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
