| Entity Name: | RAZA SHAH M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Nov 1998 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 13 Oct 2003 (21 years ago) |
| Document Number: | P98000097806 |
| FEI/EIN Number | 593542144 |
| Address: | 7319 STONEROCK CIRCLE, SUITE 106, ORLANDO, FL, 32819, US |
| Mail Address: | P.O.Box 1570, windermere, FL, 34786, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982834735 | 2009-07-15 | 2009-07-15 | PO BOX 690493, ORLANDO, FL, 328690493, US | 9430 TURKEY LAKE RD, STE 108, ORLANDO, FL, 328198015, US | |||||||||||||||||||||||
|
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| Phone | +1 407-248-9800 |
Authorized person
| Name | DR. RAZA SHAH |
| Role | PHYSICIAN-OWNER |
| Phone | 4072489800 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | ME68053 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 378390100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHAH RAZA | Agent | 7319 STONEROCK CIRCLE, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| SHAH RAZA | President | 7319 STONEROCK CIRCLE STE106, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| SHAH RAZA | Secretary | 7319 STONEROCK CIRCLE STE106, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| SHAH RAZA | Treasurer | 7319 STONEROCK CIRCLE STE106, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| SHAH RAZA | Director | 7319 STONEROCK CIRCLE STE106, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| SHAH SYEDA FVP | Vice President | 7319 STONEROCK CIRCLE, ORLANDO, FL, 32819 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-15 | 7319 STONEROCK CIRCLE, SUITE 106, ORLANDO, FL 32819 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-10 | 7319 STONEROCK CIRCLE, SUITE 106, ORLANDO, FL 32819 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-10 | 7319 STONEROCK CIRCLE, SUITE 106, ORLANDO, FL 32819 | No data |
| REINSTATEMENT | 2003-10-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2001-09-20 | SHAH, RAZA | No data |
| RESTATED ARTICLES | 2001-09-17 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-10 |
| ANNUAL REPORT | 2022-03-31 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-02-27 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-03-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
