| Entity Name: | AKSHARBRAHMA PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 11 Jan 2019 (6 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | P19000004746 |
| Address: | 6100 GREENLAND ROAD, #301, JACKSONVILLE, FL 32258 |
| Mail Address: | 6100 GREENLAND ROAD, #301, JACKSONVILLE, FL 32258 |
| ZIP code: | 32258 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851856975 | 2019-02-02 | 2019-12-31 | 6100 GREENLAND RD STE 301, JACKSONVILLE, FL, 322582626, US | 6100 GREENLAND RD STE 301, JACKSONVILLE, FL, 322582626, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 904-257-6264 |
| Fax | 9042931326 |
Authorized person
| Name | ASHISH PATEL |
| Role | PRESIDENT |
| Phone | 9042576264 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Taxonomy Code | 2080P0202X - Pediatric Cardiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102515700 |
| State | FL |
| Issuer | MEDICAID |
| Number | 102213100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL, ASHISHKUMAR | Agent | 8396 HEDGEWOOD DR, JACKSONVILLE, FL 32216 |
| Name | Role | Address |
|---|---|---|
| PATEL, ASHISHKUMAR | President | 6100 GREENLAND ROAD #301, JACKSONVILLE, FL 32258 |
| Name | Role | Address |
|---|---|---|
| PATEL, ASHISHKUMAR | Secretary | 6100 GREENLAND ROAD #301, JACKSONVILLE, FL 32258 |
| Name | Role | Address |
|---|---|---|
| PATEL, ASHISHKUMAR | Treasurer | 6100 GREENLAND ROAD #301, JACKSONVILLE, FL 32258 |
| Name | Role | Address |
|---|---|---|
| PATEL, ASHISHKUMAR | Director | 6100 GREENLAND ROAD #301, JACKSONVILLE, FL 32258 |
| PATEL, NETRALI | Director | 6100 GREENLAND ROAD #301, JACKSONVILLE, FL 32258 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2019-01-11 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
