| Entity Name: | SHAILESH SHAH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 Jan 2016 (9 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | L16000001783 |
| FEI/EIN Number | 81-1044193 |
| Address: | 8250 LAKE SERENE DRIVE, ORLANDO, FL, 32836 |
| Mail Address: | 8250 LAKE SERENE DRIVE, ORLANDO, FL, 32836 |
| ZIP code: | 32836 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1386000792 | 2016-01-14 | 2016-01-14 | 8250 LAKE SERENE DR, ORLANDO, FL, 328365023, US | 8250 LAKE SERENE DR, ORLANDO, FL, 328365023, US | |||||||||||||||||||||
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| Phone | +1 321-800-7270 |
Authorized person
| Name | DR. SHAILESH SHAH |
| Role | AMBR |
| Phone | 3218007270 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 378928400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHAH SHAILESH | Agent | 8250 LAKE SERENE DRIVE, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| SHAH SHAILESH | Authorized Member | 8250 LAKE SERENE DRIVE, ORLANDO, FL, 32836 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-03-27 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-04-19 |
| Florida Limited Liability | 2016-01-04 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
