| Entity Name: | KIRTANE ASSOCIATES, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 Sep 1982 (42 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 02 Nov 1983 (41 years ago) |
| Document Number: | G01786 |
| FEI/EIN Number | 59-2225348 |
| Address: | 210 N WESTMONTE DRIVE, ALTAMONTE SPRINGS, FL 32714 |
| Mail Address: | P.O BOX 160127, ALTAMONTE SPRINGS, FL 32716-0127 |
| ZIP code: | 32714 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174839476 | 2010-08-24 | 2010-08-24 | PO BOX 160127, ALTAMONTE SPRINGS, FL, 327160127, US | 210 N WESTMONTE DR, SUITE 1000, ALTAMONTE SPRINGS, FL, 327143311, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-788-7844 |
| Fax | 4076826071 |
Authorized person
| Name | DR. SHIRISH KAMALAKAR KIRTANE |
| Role | OWNER |
| Phone | 4077887844 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| License Number | ME37121 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME38048 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LISCENSE |
| Number | ME38048 |
| State | FL |
| Issuer | MEDICAID |
| Number | 065694100 |
| State | FL |
| Issuer | MEDICAID |
| Number | 065091900 |
| State | FL |
| Issuer | LISCENSE |
| Number | ME37121 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KIRTANE, PRAFULLA K | Agent | 210 N. WESTMONT DRIVE, ALTAMONTE SPRINGS, FL 32714 |
| Name | Role | Address |
|---|---|---|
| KIRTANE, SHIRISH K | Vice President | 210 N. WESTMONT DRIVE, ALTAMONTE SPRINGS, FL 32714 |
| Name | Role | Address |
|---|---|---|
| KIRTANE, SHIRISH K | Secretary | 210 N. WESTMONT DRIVE, ALTAMONTE SPRINGS, FL 32714 |
| Name | Role | Address |
|---|---|---|
| KIRTANE, PRAFULLA K | Director | 210 N. WESTMONT DRIVE, ALTAMONTE SPRGS,, FL 32714 |
| Name | Role | Address |
|---|---|---|
| KIRTANE, PRAFULLA K | President | 210 N. WESTMONT DRIVE, ALTAMONTE SPRGS,, FL 32714 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2012-02-26 | 210 N. WESTMONT DRIVE, ALTAMONTE SPRINGS, FL 32714 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-04-12 | KIRTANE, PRAFULLA K | No data |
| CHANGE OF MAILING ADDRESS | 1997-07-31 | 210 N WESTMONTE DRIVE, ALTAMONTE SPRINGS, FL 32714 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1986-03-14 | 210 N WESTMONTE DRIVE, ALTAMONTE SPRINGS, FL 32714 | No data |
| NAME CHANGE AMENDMENT | 1983-11-02 | KIRTANE ASSOCIATES, M.D., P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-02-04 |
| ANNUAL REPORT | 2022-02-04 |
| ANNUAL REPORT | 2021-01-17 |
| ANNUAL REPORT | 2020-04-16 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-02-21 |
| ANNUAL REPORT | 2017-01-14 |
| ANNUAL REPORT | 2016-01-31 |
| ANNUAL REPORT | 2015-01-28 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
