| Entity Name: | SHAH, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Mar 1981 (44 years ago) |
| Document Number: | F25088 |
| FEI/EIN Number | 592087438 |
| Address: | 506 Via Toledo, Palm beach garden, FL, 33418, US |
| Mail Address: | 506 Via Toledo, Palm beach garden, FL, 33418, US |
| ZIP code: | 33418 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114066685 | 2007-02-05 | 2020-08-22 | 1501 PRESIDENTIAL WAY, #12, WEST PALM BEACH, FL, 334011852, US | 1501 PRESIDENTIAL WAY, #12, WEST PALM BEACH, FL, 334011800, US | |||||||||||||||||
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| Phone | +1 561-471-9484 |
| Fax | 5614719555 |
Authorized person
| Name | DR. MALVIKA SURESH SHAH |
| Role | VICE PRESIDENT |
| Phone | 5614719484 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHAH MALVIKA | Agent | 506 VIA TOLEDO, PALM BEACH GARDENS, FL, 33418 |
| Name | Role | Address |
|---|---|---|
| SHAH, MALVIKA | Director | 506 VIA TOLEDO, PALM BCH GRDNS, FL, 33418 |
| SHAH, SURESH | Director | 506 VIA TOLEDO, PALM BCH GRDNS, FL, 33418 |
| Name | Role | Address |
|---|---|---|
| SHAH, MALVIKA | Secretary | 506 VIA TOLEDO, PALM BCH GRDNS, FL, 33418 |
| Name | Role | Address |
|---|---|---|
| SHAH, SURESH | President | 506 VIA TOLEDO, PALM BCH GRDNS, FL, 33418 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 1994-09-27 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1994-08-26 | No data | No data |
| REINSTATEMENT | 1987-12-18 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1987-11-16 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
