| Entity Name: | JAYESH S SHAH,MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Jun 2015 (10 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Mar 2016 (9 years ago) |
| Document Number: | L15000102153 |
| FEI/EIN Number | 474261549 |
| Address: | 1426 W BUSCH BLVD,, 105, TAMPA, FL, 33612-7602, US |
| Mail Address: | 1426 W BUSCH BLVD,, 105, TAMPA, FL, 33612-7602, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770697187 | 2006-08-19 | 2020-06-22 | 1426 W BUSCH BLVD, STE 105, TAMPA, FL, 336127602, US | 1426 W BUSCH BLVD, STE 105, TAMPA, FL, 336127602, US | |||||||||||||||||||||
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| Phone | +1 813-433-1002 |
| Fax | 8138776330 |
| Phone | +1 813-935-0222 |
Authorized person
| Name | JAYESH S SHAH |
| Role | OWNER / PROVIDER |
| Phone | 8139350222 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | 390003723 |
| Name | Role | Address |
|---|---|---|
| SHAH JAYSHREE J | Agent | 10631 HATTERAS DR, TAMPA, FL, 33615 |
| Name | Role | Address |
|---|---|---|
| SHAH JAYSHREE J | Manager | 10631 HATTERAS DR, TAMPA, FL, 33615 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2016-03-10 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-01-03 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-08 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-01-02 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
