| Entity Name: | ASHRAF ELSAKR, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 09 May 1997 (28 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 25 Oct 2002 (22 years ago) |
| Document Number: | P97000042452 |
| FEI/EIN Number | 59-3449131 |
| Address: | 840 DUNLAWTON AVENUE, SUITE A, PORT ORANGE, FL 32127 |
| Mail Address: | 840 DUNLAWTON AVENUE, SUITE A, PORT ORANGE, FL 32127 |
| ZIP code: | 32127 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679769293 | 2007-09-18 | 2008-07-30 | 840 DUNLAWTON AVE, SUITE A, PORT ORANGE, FL, 321274223, US | 840 DUNLAWTON AVE, SUITE A, PORT ORANGE, FL, 321274223, US | |||||||||||||||||||||||||
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| Phone | +1 386-304-9672 |
| Fax | 3863049673 |
Authorized person
| Name | DR. ASHRAF S ELSAKR |
| Role | OWNER |
| Phone | 3863049672 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| License Number | ME70981 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 250345000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ELSAKR, ASHRAF S | Agent | 840 DUNLAWTON AVE, SUITE A, PORT ORANGE, FL 32127 |
| Name | Role | Address |
|---|---|---|
| ELSAKR, ASHRAF S | Manager | P.O. BOX 291210, PORT ORANGE, FL 32129-1210 |
| Name | Role | Address |
|---|---|---|
| ELSAKR, ASHRAF S | Director | P.O. BOX 291210, PORT ORANGE, FL 32129-1210 |
| Name | Role | Address |
|---|---|---|
| ELSAKR, ASHRAF S | President | P.O. BOX 291210, PORT ORANGE, FL 32129-1210 |
| Name | Role | Address |
|---|---|---|
| ELSAKR, MONA M | secretary | P.O. BOX 291210, PORT ORANGE, FL 32129-1210 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000105348 | ADVANCED CARDIOLOGY | EXPIRED | 2015-10-15 | 2020-12-31 | No data | 840 DUNLAWTON AVE, SUITE A, PORT ORANGE, FL, 32127 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2012-02-18 | ELSAKR, ASHRAF S | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-24 | 840 DUNLAWTON AVENUE, SUITE A, PORT ORANGE, FL 32127 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-07-20 | 840 DUNLAWTON AVENUE, SUITE A, PORT ORANGE, FL 32127 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-07-20 | 840 DUNLAWTON AVE, SUITE A, PORT ORANGE, FL 32127 | No data |
| REINSTATEMENT | 2002-10-25 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2002-10-04 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| ANNUAL REPORT | 2023-04-07 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-23 |
| ANNUAL REPORT | 2019-03-13 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-03-09 |
| ANNUAL REPORT | 2016-03-09 |
| AMENDED ANNUAL REPORT | 2015-10-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
