| Entity Name: | SHAILESH SHAH, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Aug 2002 (22 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P02000092213 |
| FEI/EIN Number | 522375558 |
| Address: | 8250 LAKE SERENE DR, ORLANDO, FL, 32836, US |
| Mail Address: | 8250 LAKE SERENE DR, ORLANDO, FL, 32836 |
| ZIP code: | 32836 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790095651 | 2010-10-13 | 2013-04-27 | 8250 LAKE SERENE DR, ORLANDO, FL, 328365023, US | 8250 LAKE SERENE DR, ORLANDO, FL, 328365023, US | |||||||||||||||||
|
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| Phone | +1 407-370-0271 |
Authorized person
| Name | DR. SHAILESH SHAH |
| Role | PRESIDENT |
| Phone | 4073700271 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME67094 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHAH SHAILESH M | Agent | 8250 LAKE SERENE DR, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| SHAH SHAILESH M | President | 8250 LAKE SERENE DR, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| SHAH SHAILESH M | Secretary | 8250 LAKE SERENE DR, ORLANDO, FL, 32836 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-30 | 8250 LAKE SERENE DR, ORLANDO, FL 32836 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-07 | 8250 LAKE SERENE DR, ORLANDO, FL 32836 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-06 | 8250 LAKE SERENE DR, ORLANDO, FL 32836 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-06 | SHAH, SHAILESH MD | No data |
| CANCEL ADM DISS/REV | 2003-10-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-07 |
| ANNUAL REPORT | 2012-04-06 |
| ANNUAL REPORT | 2011-04-18 |
| ANNUAL REPORT | 2010-04-01 |
| ANNUAL REPORT | 2009-04-12 |
| ANNUAL REPORT | 2008-03-31 |
| ANNUAL REPORT | 2007-04-06 |
| ANNUAL REPORT | 2006-04-07 |
| ANNUAL REPORT | 2005-03-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
