| Entity Name: | J.P. GADIKOTA CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 31 Oct 2011 (13 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P11000094769 |
| FEI/EIN Number | 453723678 |
| Address: | 11012 NW 18 TH CT, GAINESVILLE, FL, 32606, US |
| Mail Address: | 11012 NW 18 TH CT, GAINESVILLE, FL, 32606, US |
| ZIP code: | 32606 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407159031 | 2010-12-21 | 2011-11-10 | 40 SW 12TH ST, SUITE 101 B, OCALA, FL, 344716525, US | 40 SW 12TH ST, SUITE 101 B, OCALA, FL, 344716525, US | |||||||||||||||||||||||
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| Phone | +1 352-622-1344 |
Authorized person
| Name | JAYA PRAKASH GADIKOTA |
| Role | MD |
| Phone | 3522814323 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | ME106624 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002441600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GADIKOTA JAYA P | Agent | 11012 NW 18TH CT, GAINESVILLE, FL, 32606 |
| Name | Role | Address |
|---|---|---|
| GADIKOTA JAYA P | Chief Executive Officer | 11012 NW 18TH CT, GAINESVILLE, FL, 32606 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-04 | 11012 NW 18 TH CT, GAINESVILLE, FL 32606 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-04 | 11012 NW 18 TH CT, GAINESVILLE, FL 32606 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-05-03 |
| ANNUAL REPORT | 2012-04-04 |
| Domestic Profit | 2011-10-31 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
