| Entity Name: | SHAH SHAREEF, D.O., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Apr 2019 (6 years ago) |
| Document Number: | L19000100613 |
| FEI/EIN Number | 84-1895144 |
| Address: | 5741 Bee Ridge Road, Sarasota, FL, 34233, US |
| Mail Address: | 5741 Bee Ridge Road, Sarasota, FL, 34233, US |
| ZIP code: | 34233 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366001224 | 2019-06-13 | 2023-08-04 | 5741 BEE RIDGE RD STE 570, SARASOTA, FL, 342335080, US | 5741 BEE RIDGE RD STE 570, SARASOTA, FL, 342335080, US | |||||||||||||||||||||
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| Phone | +1 941-203-8757 |
| Fax | 9415528647 |
Authorized person
| Name | SHAHJAHAN SHAREEF |
| Role | AMBR |
| Phone | 7722409190 |
Taxonomy
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | DOH |
| Number | 15795 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHAREEF NAHEED | Agent | 7892 SADDLEBROOK DRIVE, PORT SAINT LUCIE, FL, 34986 |
| Name | Role | Address |
|---|---|---|
| SHAREEF SHAHJAHAN | Authorized Member | 7892 SADDLEBROOK DRIVE, PORT SAINT LUCIE, FL, 34986 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000081262 | CORAL DERMATOLOGY | ACTIVE | 2023-07-10 | 2028-12-31 | No data | 5741 BEE RIDGE ROAD SUITE 570, SARASOTA, FL, 34233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-07-21 | 5741 Bee Ridge Road, Suite 570, Sarasota, FL 34233 | No data |
| CHANGE OF MAILING ADDRESS | 2023-07-21 | 5741 Bee Ridge Road, Suite 570, Sarasota, FL 34233 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-04-20 |
| Florida Limited Liability | 2019-04-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
