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  5. SOUTH FLORIDA NEPHROLOGY GROUP, P.A.

SOUTH FLORIDA NEPHROLOGY GROUP, P.A.

Company Details

Entity Name: SOUTH FLORIDA NEPHROLOGY GROUP, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 21 Sep 1988 (36 years ago)
Document Number: K33574
FEI/EIN Number 650074501
Address: 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071, US
Mail Address: 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071, US
ZIP code: 33071
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326136144 2006-10-10 2011-05-13 722 RIVERSIDE DR, CORAL SPRINGS, FL, 330717008, US 722 RIVERSIDE DR, CORAL SPRINGS, FL, 330717008, US

Contacts
Phone +1 954-345-4333
Fax 9543454334

Authorized person
Name DR. RACHAEL BLOOMFIELD
Role OWNER
Phone 9543454333

Taxonomy
Taxonomy Code 174400000X - Specialist
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 1326136144
State FL
Issuer TRICARE
Number 1326136144

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 401(K) RETIREMENT PLAN 2014 650074501 2015-09-22 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9543454333
Plan sponsor’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071

Signature of
Role Plan administrator
Date 2015-09-22
Name of individual signing ASGHAR CHAUDHRY
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 401(K) RETIREMENT PLAN 2013 650074501 2014-08-11 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9543454333
Plan sponsor’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071

Signature of
Role Plan administrator
Date 2014-08-11
Name of individual signing ASGHAR CHAUDHRY
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 401(K) RETIREMENT PLAN 2012 650074501 2013-09-12 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9543454333
Plan sponsor’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071

Plan administrator’s name and address
Administrator’s EIN 650074501
Plan administrator’s name SOUTH FLORIDA NEPHROLOGY GROUP, P.A.
Plan administrator’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071
Administrator’s telephone number 9543454333

Signature of
Role Plan administrator
Date 2013-09-12
Name of individual signing ASGHAR CHAUDHRY
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 401(K) RETIREMENT PLAN 2011 650074501 2012-09-17 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9543454333
Plan sponsor’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071

Plan administrator’s name and address
Administrator’s EIN 650074501
Plan administrator’s name SOUTH FLORIDA NEPHROLOGY GROUP, P.A.
Plan administrator’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071
Administrator’s telephone number 9543454333

Signature of
Role Plan administrator
Date 2012-09-17
Name of individual signing ASGHAR CHAUDHRY
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 401(K) RETIREMENT PLAN 2010 650074501 2011-08-23 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9543454333
Plan sponsor’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071

Plan administrator’s name and address
Administrator’s EIN 650074501
Plan administrator’s name SOUTH FLORIDA NEPHROLOGY GROUP, P.A.
Plan administrator’s address 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071
Administrator’s telephone number 9543454333

Signature of
Role Plan administrator
Date 2011-08-23
Name of individual signing ASGHAR CHAUDHRY
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 401(K) RETIREMENT PLAN 2009 650074501 2010-09-30 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9543454333
Plan sponsor’s address 8130 ROYAL PALM BLVD, SUITE 102, CORAL SPRINGS, FL, 33065

Plan administrator’s name and address
Administrator’s EIN 650074501
Plan administrator’s name SOUTH FLORIDA NEPHROLOGY GROUP, P.A.
Plan administrator’s address 8130 ROYAL PALM BLVD, SUITE 102, CORAL SPRINGS, FL, 33065
Administrator’s telephone number 9543454333

Signature of
Role Plan administrator
Date 2010-09-30
Name of individual signing ASGHAR CHAUDHRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CHAUDHRY ASGHAR MD Agent 7647 NW 127TH MANOR, PARKLAND, FL, 33076

President

Name Role Address
CHAUDHRY ASGHAR A President 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 330717009

Vice President

Name Role Address
GADH RAJDEEP Vice President 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 330717009

Assistant Secretary

Name Role Address
JACOB RADU Assistant Secretary 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 330717009

Asst

Name Role Address
Fernandez Victor Asst 722 RIVERSIDE DRIVE, CORAL SPRINGS, FL, 33071

Events

Event Type Filed Date Value Description
CANCEL ADM DISS/REV 2008-10-16 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2008-09-26 No data No data
NAME CHANGE AMENDMENT 2000-12-15 SOUTH FLORIDA NEPHROLOGY GROUP, P.A. No data

Related by officers

CHAUDHRY ASGHAR A

ISLAMIC CENTER OF BROWARD, INC. ASGHAR A. CHAUDHRY, M.D., P.A.

Fernandez Victor

LAKESIDE COMMONS BUSINESS CENTER CONDOMINIUM ASSOCIATION, INC.

Related by address

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NATIONWIDE CREDIT CARD & DATA SERVICES, L.L.C.

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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