| Entity Name: | VALLI SUBRAMANIAN, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Mar 1995 (30 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 09 Mar 2007 (18 years ago) |
| Document Number: | P95000025858 |
| FEI/EIN Number | 593311630 |
| Address: | 800 S. FT. HARRISON AVE., CLEARWATER, FL, 33756, US |
| Mail Address: | 800 S. FT. HARRISON AVE., CLEARWATER, FL, 33756, US |
| ZIP code: | 33756 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922379692 | 2012-01-26 | 2012-01-26 | 800 S FORT HARRISON AVE, CLEARWATER, FL, 337563902, US | 800 S FORT HARRISON AVE, CLEARWATER, FL, 337563902, US | |||||||||||||||||||||||||
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| Phone | +1 727-447-8805 |
| Fax | 7274498810 |
Authorized person
| Name | DR. VALLI SUBRAMANIAN |
| Role | PRESIDENT |
| Phone | 7274478805 |
Taxonomy
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| License Number | ME0064254 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 374059500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VALLI SUBRAMANIAN.MD.PA | Agent | 800 S FT HARRISON AVE, CLEARWATER, FL, 33756 |
| Name | Role | Address |
|---|---|---|
| SUBRAMANIAN VALLI | President | 800 S. FT. HARRISON AVE., CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-03-21 | VALLI SUBRAMANIAN.MD.PA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-25 | 800 S FT HARRISON AVE, CLEARWATER, FL 33756 | No data |
| CANCEL ADM DISS/REV | 2007-03-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-04-19 | 800 S. FT. HARRISON AVE., CLEARWATER, FL 33756 | No data |
| CHANGE OF MAILING ADDRESS | 2001-01-31 | 800 S. FT. HARRISON AVE., CLEARWATER, FL 33756 | No data |
| REINSTATEMENT | 1996-11-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1996-08-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-02-25 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-04-11 |
| ANNUAL REPORT | 2017-02-28 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
