| Entity Name: | CENTRAL FLORIDA KIDNEY SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Nov 2022 (2 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 05 Jan 2023 (2 years ago) |
| Document Number: | P22000087860 |
| FEI/EIN Number | 92-1600915 |
| Address: | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806, US |
| Mail Address: | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806, US |
| ZIP code: | 32806 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346954138 | 2023-01-06 | 2023-05-22 | 3885 OAKWATER CIR, ORLANDO, FL, 328066257, US | 3885 OAKWATER CIR, ORLANDO, FL, 328066257, US | |||||||||||||||
|
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| Phone | +1 407-816-5700 |
| Fax | 4078126766 |
Authorized person
| Name | MICHELE DEJESUS |
| Role | PRACTICE MANAGER |
| Phone | 4078165735 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| COHEN JEFFERY M | Agent | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| COHEN JEFFREY MM.D. | President | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| MADAN ARVIND M.D. | Vice President | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| MOHANLAL VIRESH M.D. | Secretary | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| BHARGAVA AMIT M.D. | Treasurer | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| SULLIVAN ROBERT M | SECO | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Name | Role | Address |
|---|---|---|
| PORTOCARRERO MIGUEL M | THIR | 3885 OAKWATER CIRCLE, ORLANDO, FL, 32806 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2023-01-05 | CENTRAL FLORIDA KIDNEY SPECIALISTS, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-02-06 |
| Name Change | 2023-01-05 |
| Domestic Profit | 2022-11-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
