| Entity Name: | OCALA HOSPITALIST GROUP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Mar 2005 (20 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P05000046670 |
| FEI/EIN Number | 510539324 |
| Address: | 1500 SW 1ST AVENUE, OCALA, FL, 34471, US |
| Mail Address: | 910 SW 1ST AVENUE, 201, OCALA, FL, 34471, US |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750409736 | 2007-03-27 | 2011-09-26 | 910 SW 1ST AVE, SUITE 201, OCALA, FL, 344710904, US | 1431 SW 1ST AVE, SUITE 280, OCALA, FL, 344716500, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 352-304-5990 |
| Fax | 3523045993 |
Authorized person
| Name | ROCKY OR LAURA KELLEY |
| Role | BILLING MANAGER |
| Phone | 3523045990 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS |
| Number | 99267 |
| Issuer | MEDICAID |
| Number | 002616400 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DD8892 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KHANNA ANISH | Agent | 695 SE 47TH LOOP, OCALA, FL, 34480 |
| Name | Role | Address |
|---|---|---|
| KHANNA ANISH | Director | 695 SE 47TH LOOP, OCALA, FL, 34480 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| AMENDMENT | 2010-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-29 | 1500 SW 1ST AVENUE, OCALA, FL 34471 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-29 | 1500 SW 1ST AVENUE, OCALA, FL 34471 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-07 | 695 SE 47TH LOOP, OCALA, FL 34480 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-01-07 | KHANNA, ANISH | No data |
| CANCEL ADM DISS/REV | 2009-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2007-10-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-03-26 |
| ANNUAL REPORT | 2014-04-24 |
| Off/Dir Resignation | 2014-01-06 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-04-25 |
| ANNUAL REPORT | 2011-04-26 |
| Amendment | 2010-09-27 |
| ANNUAL REPORT | 2010-04-29 |
| Reg. Agent Change | 2010-01-07 |
| REINSTATEMENT | 2009-09-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
