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  5. PULMONARY GROUP OF SOUTH FLORIDA, P.A.

PULMONARY GROUP OF SOUTH FLORIDA, P.A.

Company Details

Entity Name: PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Apr 1976 (49 years ago)
Document Number: 495051
FEI/EIN Number 591664154
Address: 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156, US
Mail Address: 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156, US
ZIP code: 33156
County: Miami-Dade
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2017 591664154 2018-04-23 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Signature of
Role Plan administrator
Date 2018-04-23
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2016 591664154 2017-06-08 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Signature of
Role Plan administrator
Date 2017-06-08
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2015 591664154 2016-09-01 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Signature of
Role Plan administrator
Date 2016-09-01
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2014 591664154 2015-09-01 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Signature of
Role Plan administrator
Date 2015-09-01
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2013 591664154 2014-08-25 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-01-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 591664154
Plan administrator’s name PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Plan administrator’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143
Administrator’s telephone number 3056619404

Signature of
Role Plan administrator
Date 2014-08-25
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2012 591664154 2013-08-07 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-08-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 591664154
Plan administrator’s name PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Plan administrator’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143
Administrator’s telephone number 3056619404

Signature of
Role Plan administrator
Date 2013-08-07
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2011 591664154 2012-10-08 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-08-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 591664154
Plan administrator’s name PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Plan administrator’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143
Administrator’s telephone number 3056619404

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2010 591664154 2011-06-03 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-08-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 591664154
Plan administrator’s name PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Plan administrator’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143
Administrator’s telephone number 3056619404

Signature of
Role Plan administrator
Date 2011-06-03
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2009 591664154 2010-09-27 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 17
Three-digit plan number (PN) 002
Effective date of plan 1977-08-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 591664154
Plan administrator’s name PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Plan administrator’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143
Administrator’s telephone number 3056619404

Signature of
Role Employer/plan sponsor
Date 2010-09-27
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature
PULMONARY GROUP OF SOUTH FLORIDA, P.A. PROFIT SHARING PLAN 2009 591664154 2010-09-27 PULMONARY GROUP OF SOUTH FLORIDA, P.A. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1977-08-01
Business code 621111
Sponsor’s telephone number 3056619404
Plan sponsor’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 591664154
Plan administrator’s name PULMONARY GROUP OF SOUTH FLORIDA, P.A.
Plan administrator’s address 7000 S.W. 62ND AVENUE, SUITE 201, SOUTH MIAMI, FL, 33143
Administrator’s telephone number 3056619404

Signature of
Role Plan administrator
Date 2010-09-27
Name of individual signing JEREMY TABAK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SCHERMER STEVEN J Agent 100 SE 3RD AVE, FORT LAUDERDALE, FL, 33394

Vice President

Name Role Address
PEREZ-FERNANDEZ JAVIER Vice President 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156
TABAK JEREMY I Vice President 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156
RODRIGUEZ-MORAN JUAN F Vice President 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156
FUENTES KAREL Vice President 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156
PORTILLO DOUGLAS Vice President 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156

President

Name Role Address
PARKER R. LATANAE President 8600 SW 92ND ST STE 204B, MIAMI, FL, 33156

Events

Event Type Filed Date Value Description
NAME CHANGE AMENDMENT 1998-03-27 PULMONARY GROUP OF SOUTH FLORIDA, P.A. No data
NAME CHANGE AMENDMENT 1995-04-17 PARKER, PETUSEVSKY & GIDEL, M.D.'S, P.A. No data
NAME CHANGE AMENDMENT 1995-03-28 PARKER & PETUSEVSKY, M.D.'S, P.A. No data
REINSTATEMENT 1990-01-26 No data No data
INVOLUNTARILY DISSOLVED 1989-10-13 No data No data
AMENDMENT 1984-10-02 No data No data
NAME CHANGE AMENDMENT 1984-09-07 SHILEN, PARKER & PETUSEVSKY, M.D.'S, P.A. No data
NAME CHANGE AMENDMENT 1978-06-19 SHILEN & PARKER, M.D.'S, P.A. No data

Related by officers

SCHERMER STEVEN J

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Related by address

No related companies by address

Date of last update: 01 Jan 2025

Sources: Florida Department of State

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