| Entity Name: | PURVIN SHAH, DO, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 May 2009 (16 years ago) |
| Document Number: | L09000046837 |
| FEI/EIN Number | 270171884 |
| Address: | 6679 Lake Pembroke Pl., Orlando, FL, 32829, US |
| Mail Address: | 6679 Lake Pembroke Pl., Orlando, FL, 32829, US |
| ZIP code: | 32829 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336374545 | 2009-05-18 | 2022-01-28 | 6017 PINE RIDGE RD., PMB #462, NAPLES, FL, 34119, US | 6017 PINE RIDGE RD., PMB #462, NAPLES, FL, 34119, US | |||||||||||||||||
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| Phone | +1 904-435-7993 |
Authorized person
| Name | DR. PURVIN SHAH |
| Role | PHYSICIAN |
| Phone | 9044357993 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| SHAH PURVIN | Agent | 6679 Lake Pembroke Pl., Orlando, FL, 32829 |
| Name | Role | Address |
|---|---|---|
| SHAH PURVIN | Managing Member | 6679 Lake Pembroke Pl., Orlando, FL, 32829 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-21 | 6679 Lake Pembroke Pl., Orlando, FL 32829 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-15 | 6679 Lake Pembroke Pl., Orlando, FL 32829 | No data |
| CHANGE OF MAILING ADDRESS | 2022-08-15 | 6679 Lake Pembroke Pl., Orlando, FL 32829 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-01-10 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-02-06 |
| ANNUAL REPORT | 2019-02-03 |
| ANNUAL REPORT | 2018-04-20 |
| ANNUAL REPORT | 2017-04-02 |
| ANNUAL REPORT | 2016-04-16 |
| ANNUAL REPORT | 2015-04-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
