| Entity Name: | KIDNEY CLINIC OF NORTH FLORIDA PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Apr 2021 (4 years ago) |
| Document Number: | L21000175468 |
| FEI/EIN Number | 863265908 |
| Address: | 6885 BELFORT OAKS PL #230, JACKSONVILLE, FL, 32216, US |
| Mail Address: | 4559 SWILCAN BRIDGE LANE N, JACKSONVILLE, FL, 32224, US |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467036590 | 2021-05-05 | 2022-02-10 | 1260 BEACH BLVD STE 3-422, JACKSONVILLE, FL, 322503406, US | 6885 BELFORT OAKS PL STE 230, JACKSONVILLE, FL, 322166283, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 904-744-4448 |
| Fax | 9047444048 |
| Phone | +1 904-593-5333 |
| Fax | 9045935334 |
Authorized person
| Name | GAURAV TANDON |
| Role | MD |
| Phone | 2166921956 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TANDON GAURAV | Agent | 4559 SWILCAN BRIDGE LANE N, JACKSONVILLE, FL, 32224 |
| Name | Role | Address |
|---|---|---|
| TANDON GAURAV | Authorized Member | 4559 SWILCAN BRIDGE LANE N, JACKSONVILLE, FL, 32224 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-20 | 6885 BELFORT OAKS PL #230, JACKSONVILLE, FL 32216 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-18 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-03-26 |
| Florida Limited Liability | 2021-04-15 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
