| Entity Name: | IGKHA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 06 Aug 2015 (9 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L15000135305 |
| Mail Address: | 8980 KILGORE ROAD, ORLANDO, FL 32836 |
| Address: | 724 CHARLES STREET, ORLANDO, FL 32808 |
| ZIP code: | 32808 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902282528 | 2015-08-05 | 2015-08-05 | 8980 KILGORE RD, ORLANDO, FL, 328365414, US | 724 CHARLES ST, ORLANDO, FL, 328087509, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 407-342-1896 |
| Fax | 4078768235 |
| Phone | +1 407-295-2039 |
Authorized person
| Name | GHAZALA I AHMED |
| Role | PRESIDENT |
| Phone | 4073421896 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME0059456 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 053339400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AHMED, IJAZ | Agent | 8980 KILGORE ROAD, ORLANDO, FL 32836 |
| Name | Role | Address |
|---|---|---|
| AHMED, GHAZALA, M.D. | President | 724 CHARLES STREET, ORLANDO, FL 32808 |
| Name | Role | Address |
|---|---|---|
| AHMED, IJAZ | Manager | 724 CHARLES STREET, ORLANDO, FL 32808 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000084133 | PEDIATRIC MEDICAL CENTER | EXPIRED | 2015-08-14 | 2020-12-31 | No data | 8980 KILGORE ROAD, ORLANDO, FL, 32836 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2015-08-06 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
