| Entity Name: | J SURANI PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 25 Oct 2011 (13 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: | P11000093150 |
| FEI/EIN Number | 45-3667986 |
| Address: | 1050 37TH PL., Unit 104, VERO BEACH, FL 32960 |
| Mail Address: | 1050 37TH PL., Unit 104, VERO BEACH, FL 32960 |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164724340 | 2010-11-22 | 2012-04-05 | 777 37TH ST STE B102, VERO BEACH, FL, 329604897, US | 777 37TH ST STE B102, VERO BEACH, FL, 329604897, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 772-569-3212 |
| Fax | 7725691435 |
Authorized person
| Name | PEGGIE CALAHAN |
| Role | BILLING |
| Phone | 7725693212 |
Taxonomy
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| License Number | ME103068 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003053900 |
| State | FL |
| Issuer | MEDICAID |
| Number | 002948500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SURANI, JASVANT SMD | Agent | 777 37TH STREET, SUITE B-102, VERO BEACH, FL 32960 |
| Name | Role | Address |
|---|---|---|
| SURANI, JASVANT SMD | President | 1050 37TH PL., Unit 104 VERO BEACH, FL 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-15 | 1050 37TH PL., Unit 104, VERO BEACH, FL 32960 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-15 | 1050 37TH PL., Unit 104, VERO BEACH, FL 32960 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-03-21 |
| ANNUAL REPORT | 2013-04-15 |
| Domestic Profit | 2011-10-25 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
