| Entity Name: | ORLANDO GASTROENTEROLOGY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Mar 2002 (23 years ago) |
| Document Number: | P02000026198 |
| FEI/EIN Number | 010635089 |
| Address: | 1507 S. HIAWASSEE ROAD, STE #105, ORLANDO, FL, 32835 |
| Mail Address: | 1507 S. HIAWASSEE ROAD, STE #105, ORLANDO, FL, 32835 |
| ZIP code: | 32835 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912002619 | 2006-09-14 | 2013-01-03 | 1507 S HIAWASSEE RD, STE# 105, ORLANDO, FL, 328355718, US | 1507 S HIAWASSEE RD, STE# 105, ORLANDO, FL, 328355718, US | |||||||||||||||||||||||||
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| Phone | +1 407-445-9224 |
| Fax | 4074456236 |
Authorized person
| Name | DR. SRIKIRAN POTHAMSETTY |
| Role | PRESIDENT |
| Phone | 4074459224 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| License Number | ME82603 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 263820700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| POTHAMSETTY SRIKIRAN | Agent | 1507 S. HIAWASSEE RD, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| POTHAMSETTY SRIKIRAN | President | 1507 S. HIAWASSEE RD STE 105, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| POTHAMSETTY SRIKIRAN | Secretary | 1507 S. HIAWASSEE RD STE 105, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| POTHAMSETTY SRIKIRAN | Treasurer | 1507 S. HIAWASSEE RD STE 105, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| POTHAMSETTY SRIKIRAN | Director | 1507 S. HIAWASSEE RD STE 105, ORLANDO, FL, 32835 |
| Name | Role | Address |
|---|---|---|
| Pothamsetty Revati | Manager | 1507 S. HIAWASSEE ROAD, ORLANDO, FL, 32835 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-26 | 1507 S. HIAWASSEE ROAD, STE #105, ORLANDO, FL 32835 | No data |
| CHANGE OF MAILING ADDRESS | 2007-04-26 | 1507 S. HIAWASSEE ROAD, STE #105, ORLANDO, FL 32835 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-05-05 | 1507 S. HIAWASSEE RD, STE 105, ORLANDO, FL 32835 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-03-07 | POTHAMSETTY, SRIKIRAN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-03-01 |
| ANNUAL REPORT | 2016-04-12 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
