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MATHURA MEDICAL GROUP INC. - Florida Company Profile

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Company Details

Entity Name: MATHURA MEDICAL GROUP INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 18 May 2021 (4 years ago)
Last Event: AMENDMENT
Event Date Filed: 04 Feb 2022 (4 years ago)
Document Number: N21000005849
FEI/EIN Number 863907911
Address: 110 Pond st, ste 203, Debary, FL, 32713, US
Mail Address: 110 Pond st, ste 203, Debary, FL, 32713, US
ZIP code: 32713
City: Debary
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
MATHURA SHIVA President 110 Pond st, Debary, FL, 32713
MATHURA SHIVA Agent 307 E. 2ND ST, SANFORD, FL, 32771

U.S. Small Business Administration Profile

Phone Number:
Contact Person:
SHIVA MATHURA
Ownership and Self-Certifications:
Other Minority Owned, Self-Certified Small Disadvantaged Business, Subcontinent Asian American, Veteran
User ID:
P2648978

Unique Entity ID

Unique Entity ID:
TG88J8R4VMP9
CAGE Code:
957C6
UEI Expiration Date:
2025-11-13

Business Information

Activation Date:
2024-11-20
Initial Registration Date:
2021-08-24

Commercial and government entity program

CAGE number:
957C6
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-11-20
CAGE Expiration:
2029-11-20
SAM Expiration:
2025-11-13

Contact Information

POC:
SHIVA MATHURA
Corporate URL:
www.mathuramedical.com

National Provider Identifier

NPI Number:
1871160960
Certification Date:
2023-06-28

Authorized Person:

Name:
DR. SHIVA A MATHURA
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8665541654

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-04-15 110 Pond st, ste 203, Debary, FL 32713 -
CHANGE OF MAILING ADDRESS 2022-04-15 110 Pond st, ste 203, Debary, FL 32713 -
REGISTERED AGENT ADDRESS CHANGED 2022-04-15 307 E. 2ND ST, SANFORD, FL 32771 -
AMENDMENT 2022-02-04 - -

Documents

Name Date
ANNUAL REPORT 2024-04-14
ANNUAL REPORT 2023-03-27
ANNUAL REPORT 2022-04-15
Amendment 2022-02-04
Domestic Non-Profit 2021-05-18

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Date of last update: 03 Aug 2025

Sources: Florida Department of State