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  5. PEDIATRICS OF CENTRAL FLORIDA, P.A.

PEDIATRICS OF CENTRAL FLORIDA, P.A.

Company Details

Entity Name: PEDIATRICS OF CENTRAL FLORIDA, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 19 Oct 1984 (40 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 06 Oct 1993 (31 years ago)
Document Number: H26396
FEI/EIN Number 59-2458329
Address: 801 W. OAK STREET, SUITE 101, KISSIMMEE, FL 34741
Mail Address: 801 W. OAK STREET, SUITE 101, KISSIMMEE, FL 34741
ZIP code: 34741
County: Osceola
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1629746870 2021-09-02 2021-09-02 801 W OAK ST STE 101, KISSIMMEE, FL, 347416605, US 11183 S ORANGE BLOSSOM TRL STE C, ORLANDO, FL, 328379402, US

Contacts
Phone +1 407-846-3455
Fax 4078467381
Phone +1 407-857-2816
Fax 4078579560

Authorized person
Name RUPA DESAI
Role OFFICE MANAGER
Phone 4078463455

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 104022200
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2023 592458329 2024-04-16 PEDIATRICS OF CENTRAL FLORIDA, P.A. 46
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463804
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2022 592458329 2023-06-13 PEDIATRICS OF CENTRAL FLORIDA, P.A. 44
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463804
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2021 592458329 2022-04-20 PEDIATRICS OF CENTRAL FLORIDA, P.A. 46
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2020 592458329 2021-05-05 PEDIATRICS OF CENTRAL FLORIDA, P.A. 47
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2019 592458329 2020-08-20 PEDIATRICS OF CENTRAL FLORIDA, P.A. 44
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2018 592458329 2019-04-11 PEDIATRICS OF CENTRAL FLORIDA, P.A. 43
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2017 592458329 2018-07-30 PEDIATRICS OF CENTRAL FLORIDA, P.A. 49
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2016 592458329 2017-04-27 PEDIATRICS OF CENTRAL FLORIDA, P.A. 44
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2015 592458329 2016-05-09 PEDIATRICS OF CENTRAL FLORIDA, P.A. 42
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741
PEDIATRICS OF CENTRAL FLORIDA, P.A. REVISED AND RESTATED PROFIT SHARING PLAN 2014 592458329 2015-06-22 PEDIATRICS OF CENTRAL FLORIDA, P.A. 39
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4078463455
Plan sponsor’s address 801 WEST OAK STREET, SUITE 101, KISSIMMEE, FL, 34741

Agent

Name Role Address
JANARIOUS, MARY K M.D. Agent 801 W. OAK STREET, SUITE 101, KISSIMMEE, FL 34741

Pres.

Name Role Address
JANARIOUS, MARY K, M.D. Pres. 801 W. OAK ST., STE. 101, KISSIMMEE, FL 34741

Asst. Treasurer

Name Role Address
WATANE, ARCHANA A, M.D. Asst. Treasurer 801 WEST OAK STREET SUITE 101, KISSIMMEE, FL 34741

and Secretary

Name Role Address
WATANE, ARCHANA A, M.D. and Secretary 801 WEST OAK STREET SUITE 101, KISSIMMEE, FL 34741

V.P and Treasurer

Name Role Address
RAGHAVAN, VASANTHY M.D. V.P and Treasurer 801 W OAK STREET STE 101, KISSIMMEE, FL 34741

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2009-04-03 JANARIOUS, MARY K M.D. No data
CHANGE OF PRINCIPAL ADDRESS 2005-04-01 801 W. OAK STREET, SUITE 101, KISSIMMEE, FL 34741 No data
CHANGE OF MAILING ADDRESS 2005-04-01 801 W. OAK STREET, SUITE 101, KISSIMMEE, FL 34741 No data
REGISTERED AGENT ADDRESS CHANGED 2005-04-01 801 W. OAK STREET, SUITE 101, KISSIMMEE, FL 34741 No data
NAME CHANGE AMENDMENT 1993-10-06 PEDIATRICS OF CENTRAL FLORIDA, P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-04-17
ANNUAL REPORT 2022-04-06
ANNUAL REPORT 2021-04-06
ANNUAL REPORT 2020-06-19
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-04-05
ANNUAL REPORT 2017-04-10
ANNUAL REPORT 2016-04-22
ANNUAL REPORT 2015-03-18

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 04 Feb 2025

Sources: Florida Department of State

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