| Entity Name: | CORAL SPRINGS MEDICAL GROUP INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 23 Mar 2018 (7 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 09 Mar 2020 (5 years ago) |
| Document Number: | P18000028292 |
| FEI/EIN Number | 82-4966634 |
| Address: | 10000 WEST SAMPLE RD, CORAL SPRINGS, FL, 33065, US |
| Mail Address: | 10000 WEST SAMPLE RD, CORAL SPRINGS, FL, 33065, US |
| ZIP code: | 33065 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255824157 | 2018-06-14 | 2023-05-31 | 10000 W SAMPLE RD, CORAL SPRINGS, FL, 330653936, US | 10000 W SAMPLE RD, CORAL SPRINGS, FL, 330653936, US | |||||||||||||
|
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| Phone | +1 754-812-1000 |
Authorized person
| Name | KHYATI V SOLANKI |
| Role | BILLING MANAGER |
| Phone | 5615742214 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GAJRAJ JASON N | Agent | 10000 WEST SAMPLE RD, CORAL SPRINGS, FL, 33065 |
| Name | Role | Address |
|---|---|---|
| Gajraj Jason N | Director | 10000 West Sample Road, Coral Springs, FL, 33065 |
| GAJRAJ MOHAMED H | Director | 10000 West Sample Road, Coral Springs, FL, 33065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-09 | 10000 WEST SAMPLE RD, SUITE A, CORAL SPRINGS, FL 33065 | No data |
| AMENDMENT | 2020-03-09 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-09 | 10000 WEST SAMPLE RD, SUITE A, CORAL SPRINGS, FL 33065 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-03-09 | GAJRAJ, JASON N. | No data |
| REINSTATEMENT | 2019-10-18 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-10-18 | 10000 WEST SAMPLE RD, SUITE A, CORAL SPRINGS, FL 33065 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-29 |
| Amendment | 2020-03-09 |
| REINSTATEMENT | 2019-10-18 |
| Domestic Profit | 2018-03-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
