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  5. JAYENDRA CHOKSI, M.D., P.A.

JAYENDRA CHOKSI, M.D., P.A.

Company Details

Entity Name: JAYENDRA CHOKSI, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 22 Oct 1992 (32 years ago)
Date of dissolution: 27 Sep 2019 (5 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2019 (5 years ago)
Document Number: V73326
FEI/EIN Number 65-0360885
Address: 2420 Carroll Place, Tampa, FL 33612
Mail Address: 2420 Carroll Place, Tampa, FL 33612
ZIP code: 33612
County: Hillsborough
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2019 650360885 2020-08-12 JAYENDRA CHOKSI, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2018 650360885 2019-09-30 JAYENDRA CHOKSI, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2017 650360885 2018-09-30 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2016 650360885 2018-01-18 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2015 650360885 2016-10-14 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing JAYENDRA CHOKSI
Valid signature Filed with authorized/valid electronic signature
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2014 650360885 2015-10-12 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing JAYENDRA CHOKSI
Valid signature Filed with authorized/valid electronic signature
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2013 650360885 2014-07-15 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246

Signature of
Role Plan administrator
Date 2014-07-15
Name of individual signing JAYENDRA CHOKSI
Valid signature Filed with authorized/valid electronic signature
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2012 650360885 2013-09-23 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246

Signature of
Role Plan administrator
Date 2013-09-23
Name of individual signing JAYENDRA CHOKSI
Valid signature Filed with authorized/valid electronic signature
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2011 650360885 2012-10-02 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246

Signature of
Role Plan administrator
Date 2012-10-02
Name of individual signing JAYENDRA CHOKSI
Valid signature Filed with authorized/valid electronic signature
JAYENDRA CHOKSI, M.D., P.A. PENSION PLAN 2010 650360885 2011-09-27 JAYENDRA CHOKSI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621112
Sponsor’s telephone number 8139313246
Plan sponsor’s address 2420 CARROLL PL, TAMPA, FL, 336126521

Plan administrator’s name and address
Administrator’s EIN 650360885
Plan administrator’s name JAYENDRA CHOKSI, M.D., P.A.
Plan administrator’s address 2420 CARROLL PL, TAMPA, FL, 336126521
Administrator’s telephone number 8139313246

Signature of
Role Plan administrator
Date 2011-09-27
Name of individual signing JAYENDRA CHOKSI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Jayendra Choksi, MD., PA Agent 2420 W carroll Place, Tampa, FL 33612

Director

Name Role Address
CHOKSI, JAYENDRA Director 2630 WEST WATERS AVE., TAMPA, FL 33614
CHOKSI, SHAILA Director 2630 W WATERS AVE, TAMPA, FL 33614

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000011541 PROFESSIONAL PSYCHIATRIC ASSOCIATES EXPIRED 2010-02-04 2015-12-31 No data 2630 WEST WATERS AVE, TAMPA, FL, 33614

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 No data No data
CHANGE OF PRINCIPAL ADDRESS 2018-04-25 2420 Carroll Place, Tampa, FL 33612 No data
CHANGE OF MAILING ADDRESS 2018-04-25 2420 Carroll Place, Tampa, FL 33612 No data
REGISTERED AGENT NAME CHANGED 2013-04-16 Jayendra Choksi, MD., PA No data
REGISTERED AGENT ADDRESS CHANGED 2013-04-16 2420 W carroll Place, Tampa, FL 33612 No data

Documents

Name Date
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-04-06
ANNUAL REPORT 2016-04-04
ANNUAL REPORT 2015-04-29
ANNUAL REPORT 2014-04-23
ANNUAL REPORT 2013-04-16
ANNUAL REPORT 2012-04-24
ANNUAL REPORT 2011-04-20
ANNUAL REPORT 2010-04-15
ANNUAL REPORT 2009-04-06

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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