| Entity Name: | INTRACOASTAL MEDICAL PRIMARY HEALTH CARE INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Apr 2012 (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: | P12000035880 |
| FEI/EIN Number | 45-5343304 |
| Address: | 935 INTRACOASTAL DRIVE, FORT LAUDERDALE, FL, 33304 |
| Mail Address: | 935 INTRACOASTAL DRIVE, FORT LAUDERDALE, FL, 33304 |
| ZIP code: | 33304 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861752784 | 2012-05-24 | 2013-06-17 | 935 INTRACOASTAL DR, SUITE 1, FORT LAUDERDALE, FL, 333043623, US | 935 INTRACOASTAL DR, SUITE 1, FORT LAUDERDALE, FL, 333043623, US | |||||||||||||||
|
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| Phone | +1 954-561-6252 |
| Fax | 9545307516 |
Authorized person
| Name | HARISH CHOWDARY |
| Role | DPST |
| Phone | 7863024902 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHOWDHARY HARRISH | Agent | 711 SE 16TH CT, FORT LAUDERDALE, FL, 33316 |
| Name | Role | Address |
|---|---|---|
| CHOWDHARY VIJAY J | Director | 935 INTRACOASTAL DRIVE, FORT LAUDERDALE, FL, 33304 |
| Name | Role | Address |
|---|---|---|
| CHOWDHARY VIJAY J | President | 935 INTRACOASTAL DRIVE, FORT LAUDERDALE, FL, 33304 |
| Name | Role | Address |
|---|---|---|
| CHOWDHARY VIJAY J | Secretary | 935 INTRACOASTAL DRIVE, FORT LAUDERDALE, FL, 33304 |
| Name | Role | Address |
|---|---|---|
| CHOWDHARY VIJAY J | Treasurer | 935 INTRACOASTAL DRIVE, FORT LAUDERDALE, FL, 33304 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-29 | CHOWDHARY, HARRISH | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-29 | 711 SE 16TH CT, FORT LAUDERDALE, FL 33316 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-29 |
| Domestic Profit | 2012-04-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
