| Entity Name: | GREGORY L. NEDURIAN, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Oct 2005 (19 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 25 Aug 2010 (14 years ago) |
| Document Number: | P05000142404 |
| FEI/EIN Number | 203649322 |
| Address: | 521 BUENA VISTA ST, LAKELAND, FL, 33805-4504, US |
| Mail Address: | 1706 CHARLESTON WOODS CT, PLANT CITY, FL, 33566-0954 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265566012 | 2007-03-15 | 2008-04-23 | 521 BUENA VISTA ST, LAKELAND, FL, 338054504, US | 521 BUENA VISTA ST, LAKELAND, FL, 338054504, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-687-0550 |
| Fax | 8636827700 |
Authorized person
| Name | DR. GREGORY L. NEDURIAN |
| Role | CORPORATE PRESIDENT |
| Phone | 8636870550 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME0090819 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 270400500 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | P00279741 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NEDURIAN GREGORY L | Agent | 1706 CHARLESTON WOODS CT, PLANT CITY, FL, 33566 |
| Name | Role | Address |
|---|---|---|
| NEDURIAN GREGORY L | President | 521 BUENA VISTA ST, LAKELAND, FL, 338054504 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-03 | 1706 CHARLESTON WOODS CT, PLANT CITY, FL 33566 | No data |
| REINSTATEMENT | 2010-08-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-08-25 | 521 BUENA VISTA ST, LAKELAND, FL 33805-4504 | No data |
| CHANGE OF MAILING ADDRESS | 2010-08-25 | 521 BUENA VISTA ST, LAKELAND, FL 33805-4504 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-08-25 | NEDURIAN, GREGORY L | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2008-11-03 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2006-12-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J11000202015 | TERMINATED | 11-CA-002524 | HILLSBOROUGH COUNTY | 2011-01-26 | 2016-04-04 | $45,824.70 | LYON FINANCIAL SERVICES, INC., 1310 MADRID STREET, SUITE 100, MARSHALL, MN 56258 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-03-16 |
| ANNUAL REPORT | 2022-02-17 |
| ANNUAL REPORT | 2021-04-17 |
| ANNUAL REPORT | 2020-02-06 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
