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PENSACOLA PEDIATRICS, P.A.

PENSACOLA PEDIATRICS, P.A. - Florida Company Profile

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Company Details

Entity Name:	PENSACOLA PEDIATRICS, P.A.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Active
Date Filed:	28 Dec 1987 (38 years ago)
Last Event:	AMENDMENT
Event Date Filed:	16 Aug 2023 (2 years ago)
Document Number:	K09119
FEI/EIN Number	592864937
Address:	4951 GRANDE DRIVE, PENSACOLA, FL, 32504, US
Mail Address:	4400 BAYOU BLVD SUITE 46, PENSACOLA, FL, 32503, US
ZIP code:	32504
City:	Pensacola
County:	Escambia
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
KLEIN PAMELA M	Vice President	4951 GRANDE DRIVE, PENSACOLA, FL, 32504
LENGA HEATHER	President	4951 GRANDE DRIVE, PENSACOLA, FL, 32504
REESE RANDALL EDR	Secretary	4951 GRANDE DRIVE, PENSACOLA, FL, 32504
FOLAND AMY P	Vice President	4951 GRANDE DRIVE, PENSACOLA, FL, 32504
EWERT JESSICA CDr.	Vice President	4951 GRANDE DRIVE, PENSACOLA, FL, 32504
ANDREWS CAROL MDr.	Vice President	4951 GRANDE DRIVE, PENSACOLA, FL, 32504
LENGA HEATHER H	Agent	4951 GRANDE DR, PENSACOLA, FL, 32504

Unique Entity ID

Unique Entity ID:

X2L1FCNSVM94

CAGE Code:

7X5U4

UEI Expiration Date:

2026-01-17

Business Information

Activation Date:

2025-01-21

Initial Registration Date:

2017-08-08

Commercial and government entity program

CAGE number:

7X5U4

Status:

Obsolete

Type:

Non-Manufacturer

CAGE Update Date:

2025-01-21

SAM Expiration:

2026-01-17

Contact Information

POC:

NATHANIAL FERGUSON

National Provider Identifier

NPI Number:

1801649686

Certification Date:

2024-04-10

Link:

View on NPI website

Authorized Person:

Name:

PETER HECKATHORN

Role:

ADMINISTRATOR

Phone:

8504730100

Taxonomy:

Selected Taxonomy:

208000000X - Pediatrics Physician

Is Primary:

Yes

Contacts:

Phone:

+1 850-473-0100

Fax:

8504730500

Form 5500 Series

Employer Identification Number (EIN):

592864937

Plan Year:

2023

Number Of Participants:

108

Sponsors Telephone Number:

8507720659

File:

Plan Year:

2022

Number Of Participants:

109

Sponsors Telephone Number:

8507720659

File:

Plan Year:

2021

Number Of Participants:

116

Sponsors Telephone Number:

8504715040

File:

Plan Year:

2020

Number Of Participants:

104

Sponsors Telephone Number:

8504715040

File:

Plan Year:

2019

Number Of Participants:

104

Sponsors Telephone Number:

8504715040

File:

Events

Event Type	Filed Date	Value	Description
AMENDMENT	2023-08-16	-	-
CHANGE OF MAILING ADDRESS	2023-02-16	4951 GRANDE DRIVE, PENSACOLA, FL 32504	-
REGISTERED AGENT NAME CHANGED	2014-02-25	LENGA, HEATHER H	-
CHANGE OF PRINCIPAL ADDRESS	1999-08-03	4951 GRANDE DRIVE, PENSACOLA, FL 32504	-
REGISTERED AGENT ADDRESS CHANGED	1999-08-03	4951 GRANDE DR, PENSACOLA, FL 32504	-
NAME CHANGE AMENDMENT	1992-02-21	PENSACOLA PEDIATRICS, P.A.	-
NAME CHANGE AMENDMENT	1988-04-22	TWELFTH AVENUE CHILDREN'S CLINIC, P.A.	-

Documents

Name	Date
ANNUAL REPORT	2024-02-23
Amendment	2023-08-16
ANNUAL REPORT	2023-02-16
ANNUAL REPORT	2022-03-22
ANNUAL REPORT	2021-03-29
ANNUAL REPORT	2020-02-19
ANNUAL REPORT	2019-02-22
ANNUAL REPORT	2018-03-05
ANNUAL REPORT	2017-01-17
ANNUAL REPORT	2016-02-01

Paycheck Protection Program

Jobs Reported:

114

Initial Approval Amount:

$1,144,300

Date Approved:

2020-04-13

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$1,144,300

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$1,159,505.08

Servicing Lender:

Regions Bank

Use of Proceeds:

Payroll: $1,144,300

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Date of last update: 03 Aug 2025

Sources: Florida Department of State