| Entity Name: | INDI VASUDEVA NEPHROLOGY, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Nov 2021 (3 years ago) |
| Document Number: | P21000094083 |
| FEI/EIN Number | 87-3464999 |
| Address: | 4218 W. LINEBAUGH AVE, TAMPA, FL, 33624, US |
| Mail Address: | 20004 Wellington Manor Blvd, Lutz, FL, 33549, US |
| ZIP code: | 33624 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538828918 | 2021-12-13 | 2021-12-13 | 2410 NORTHSIDE DR, CLEARWATER, FL, 337612236, US | 4218 W LINEBAUGH AVE, TAMPA, FL, 336245241, US | |||||||||||||||||||
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| Phone | +1 727-499-0351 |
| Fax | 7277813312 |
| Phone | +1 813-269-7555 |
| Fax | 8132697575 |
Authorized person
| Name | DR. INDI VASUDEVA |
| Role | OWNER |
| Phone | 8137779605 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VASUDEVA INDI P | Agent | 4218 W. LINEBAUGH AVE, TAMPA,, FL, 33624 |
| Name | Role | Address |
|---|---|---|
| VASUDEVA INDI P | President | 4218 W. LINEBAUGH AVE, TAMPA, FL, 33624 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-01-30 | 4218 W. LINEBAUGH AVE, TAMPA, FL 33624 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-20 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-03-14 |
| Domestic Profit | 2021-11-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
