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  5. AMIT CHOKSHI, MD PA

AMIT CHOKSHI, MD PA

Company Details

Entity Name: AMIT CHOKSHI, MD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 25 Jan 2008 (17 years ago)
Date of dissolution: 09 Aug 2016 (8 years ago)
Last Event: VOLUNTARY DISS W/ NOTICE
Event Date Filed: 09 Aug 2016 (8 years ago)
Document Number: P08000009356
FEI/EIN Number 261850609
Address: 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL, 32207
Mail Address: 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL, 32207
ZIP code: 32207
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114201381 2011-10-05 2011-10-05 3890 DUNN AVE, STE 902, JACKSONVILLE, FL, 322186428, US 3890 DUNN AVE, STE 902, JACKSONVILLE, FL, 322186428, US

Contacts
Phone +1 904-346-3506

Authorized person
Name AMIT CHOKSHI
Role OWNER
Phone 9043463506

Taxonomy
Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMIT CHOKSHI MD, PA 401(K) PLAN 2014 261850609 2015-10-15 AMIT CHOKSHI MD, PA 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9043463506
Plan sponsor’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing AMIT CHOKSHI, MD
Valid signature Filed with authorized/valid electronic signature
AMIT CHOKSHI MD, PA 401(K) PLAN 2014 261850609 2015-10-15 AMIT CHOKSHI MD, PA 10
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9043463506
Plan sponsor’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing AMIT CHOKSHI, MD
Valid signature Filed with authorized/valid electronic signature
AMIT CHOKSHI MD, PA 401(K) PLAN 2013 261850609 2014-07-28 AMIT CHOKSHI MD, PA 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9043463506
Plan sponsor’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing AMIT CHOKSHI, MD
Valid signature Filed with authorized/valid electronic signature
AMIT CHOKSHI MD, PA 401(K) PLAN 2012 261850609 2013-07-26 AMIT CHOKSHI MD, PA 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9043463506
Plan sponsor’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207

Plan administrator’s name and address
Administrator’s EIN 261850609
Plan administrator’s name AMIT CHOKSHI MD, PA
Plan administrator’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207
Administrator’s telephone number 9043463506

Signature of
Role Plan administrator
Date 2013-07-26
Name of individual signing AMIT CHOKSHI, MD
Valid signature Filed with authorized/valid electronic signature
AMIT CHOKSHI MD, PA 401(K) PLAN 2011 261850609 2012-10-15 AMIT CHOKSHI MD, PA 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9043463506
Plan sponsor’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207

Plan administrator’s name and address
Administrator’s EIN 261850609
Plan administrator’s name AMIT CHOKSHI MD, PA
Plan administrator’s address 1325 SAN MARCO BLVD. SUITE 900, JACKSONVILLE, FL, 32207
Administrator’s telephone number 9043463506

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing AMIT CHOKSHI, MD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CRAMER CHARLES W Agent 1411 EDGEWATER DRIVE, ORLANDO, FL, 32804

President

Name Role Address
CHOKSHI AMIT R President 11695 KINGS MOUNTAIN WAY, JACKSONVILLE, FL, 32256

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000008178 CHOKSHI & COLUCCELLI EYE INSTITUTE EXPIRED 2012-01-24 2017-12-31 No data 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL, 32207
G11000109718 TILLIS EYE CARE CENTER EXPIRED 2011-11-10 2016-12-31 No data 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL, 32207
G11000108460 SEE CLEAR OPTICAL EXPIRED 2011-11-07 2016-12-31 No data 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL, 32207

Events

Event Type Filed Date Value Description
VOLUNTARY DISS W/ NOTICE 2016-08-09 No data No data
CHANGE OF PRINCIPAL ADDRESS 2010-04-15 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL 32207 No data
CHANGE OF MAILING ADDRESS 2010-04-15 1325 SAN MARCO BLVD., SUITE 900, JACKSONVILLE, FL 32207 No data

Documents

Name Date
CORAPVDWN 2016-08-09
ANNUAL REPORT 2015-03-10
ANNUAL REPORT 2014-04-30
ANNUAL REPORT 2013-04-09
ANNUAL REPORT 2012-04-26
ANNUAL REPORT 2011-03-29
ANNUAL REPORT 2010-04-15
ANNUAL REPORT 2009-04-03
Domestic Profit 2008-01-25

Related by officers

CHOKSHI AMIT R

EYE ASC, LLC SAC REALTY, LLC

CRAMER CHARLES W

HTK MEDIA, LLC SILVERTON STUDIO, LLC M & M FUTURES, LLC SPECIAL PRODUCTS INTERNATIONAL, INC. EMBASSY BLUE INSTITUTE, INC. GLOBAL MED ADVANTAGE, LLC KOINONIA MANAGEMENT SERVICES, INC. 2600 LEE ROAD PROPERTY, LLC 323 CORPORATION AREOPAGUS, LLC

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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