| Entity Name: | KAMLESH P. PANDYA, MD LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
KAMLESH P. PANDYA, MD LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 04 Sep 2015 (10 years ago) |
| Date of dissolution: | 15 Jun 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 15 Jun 2020 (5 years ago) |
| Document Number: | L15000151798 |
| FEI/EIN Number |
81-1029227
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2100 Nebraska Ave Suite 202, Fort Pierce, FL, 34950, US |
| Mail Address: | 2100 Nebraska Ave Suite 202, Fort Pierce, FL, 34950, US |
| ZIP code: | 34950 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659738789 | 2016-01-20 | 2017-01-05 | 8980 S US HIGHWAY 1, SUITE 101, PORT ST LUCIE, FL, 349523482, US | 8980 S US HIGHWAY 1, SUITE 101, PORT ST LUCIE, FL, 349523482, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-807-6500 |
| Fax | 7728076501 |
Authorized person
| Name | DR. KAMLESH P PANDYA |
| Role | OWNER |
| Phone | 7728076500 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| License Number | FL ME0059031 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | FL ME0059031 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207RS0012X - Sleep Medicine (Internal Medicine) Physician |
| License Number | FL ME0059031 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 051911100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PANDYA KAMLESH P | Manager | 2100 Nebraska Ave Suite 202, Fort Pierce, FL, 34950 |
| Pandya Jagruti P | Chief Executive Officer | 2100 Nebraska Ave Suite 202, Fort Pierce, FL, 34950 |
| PANDYA KAMLESH P | Agent | 2100 Nebraska Ave Suite 202, Fort Pierce, FL, 34950 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-06-15 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-04 | 2100 Nebraska Ave Suite 202, Fort Pierce, FL 34950 | - |
| CHANGE OF MAILING ADDRESS | 2019-04-04 | 2100 Nebraska Ave Suite 202, Fort Pierce, FL 34950 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-04 | 2100 Nebraska Ave Suite 202, Fort Pierce, FL 34950 | - |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-06-15 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-04-06 |
| Florida Limited Liability | 2015-09-04 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2446097308 | 2020-04-29 | 0455 | PPP | 2100 Nebraska Ave SUITE 202, FORT PIERCE, FL, 34950-0000 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
