| Entity Name: | GAURAV N. MATHUR, MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 Dec 2022 (2 years ago) |
| Document Number: | P23000000718 |
| FEI/EIN Number | 92-1682078 |
| Address: | 1185 SANDPINE CIRCLE, TITUSVILLE, FL 32796 |
| Mail Address: | 1185 SANDPINE CIRCLE, TITUSVILLE, FL 32796 |
| ZIP code: | 32796 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407533573 | 2023-06-30 | 2023-06-30 | PO BOX 1494, TITUSVILLE, FL, 327811494, US | 7139 N US HIGHWAY 1, PORT ST JOHN, FL, 329275094, US | |||||||||||||
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| Phone | +1 321-621-0476 |
Authorized person
| Name | GAURAV NARAYAN MATHUR |
| Role | MD/CEO |
| Phone | 3216210476 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| DISALVO AND COMPANY, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| MATHUR, GAURAV N | President | 1185 SANDPINE CIRCLE, TITUSVILLE, FL 32796 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000130711 | TOTALHEALTH AND RECOVERY | ACTIVE | 2024-10-24 | 2029-12-31 | No data | 1185 SAND PINE CIRCLE, TITUSVILLE, FL, 32796 |
| G24000112504 | MATHUR CLINIC: TOTALHEALTH AND RECOVERY | ACTIVE | 2024-09-09 | 2029-12-31 | No data | 1185 SAND PINE CIRCLE, TITUSVILLE, FL, 32796 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-26 |
| Domestic Profit | 2022-12-29 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
