| Entity Name: | GK BANSAL RHEUMATOLOGY PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Dec 2023 (a year ago) |
| Document Number: | L23000537596 |
| FEI/EIN Number | 93-4731600 |
| Address: | 12386 STATE ROAD 535, #249, ORLANDO, FL 32836 |
| Mail Address: | 12386 STATE ROAD 535, #249, ORLANDO, FL 32836 |
| ZIP code: | 32836 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275396608 | 2024-01-30 | 2024-01-30 | 12386 STATE ROAD 535, ORLANDO, FL, 328366701, US | 7932 W SAND LAKE RD STE 200, ORLANDO, FL, 328197299, US | |||||||||||||||||||
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| Phone | +1 407-355-7759 |
| Fax | 4073554987 |
Authorized person
| Name | MR. FARHAN SHAH |
| Role | MANAGER |
| Phone | 2394448185 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RR0500X - Rheumatology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DESAI, TUSHAAR | Agent | 1916 EAST ROBINSON STREET, ORLANDO, FL 32803 |
| Name | Role | Address |
|---|---|---|
| BANSAL, PANKAJ | Managing Member | 12386 STATE ROAD 535, #249, ORLANDO, FL 32836 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000149124 | ORLANDO ARTHRITIS AND RHEUMATOLOGY CLINIC | ACTIVE | 2023-12-09 | 2028-12-31 | No data | 12386 STATE ROAD 535, #249, ORLANDO, FL, 32836 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-07 |
| ANNUAL REPORT | 2024-04-25 |
| Florida Limited Liability | 2023-12-04 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
