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  5. FLORIDA INTERNAL MEDICINE, PL

FLORIDA INTERNAL MEDICINE, PL

Company Details

Entity Name: FLORIDA INTERNAL MEDICINE, PL
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 26 Apr 2005 (20 years ago)
Document Number: L05000040796
FEI/EIN Number 202768583
Address: 3016 PALERMO CT, MOUNT DORA, FL, 32757, US
Mail Address: 3016 PALERMO CT, MOUNT DORA, FL, 32757
ZIP code: 32757
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912954439 2006-05-29 2011-01-10 3016 PALERMO CT, MOUNT DORA, FL, 327576527, US 620 S LAKE ST, SUITE# 6, LEESBURG, FL, 347486059, US

Contacts
Phone +1 352-383-8209
Fax 3523838209
Phone +1 352-365-0099
Fax 3523150578

Authorized person
Name DR. DWARAKNADH R BANALA
Role OWNER
Phone 3523650099

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number ME80590
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA INTERNAL MEDICINE, PL 401(K) PLAN 2023 202768583 2024-10-09 FLORIDA INTERNAL MEDICINE, PL 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 202768583
Plan administrator’s name FLORIDA INTERNAL MEDICINE, PL
Plan administrator’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523650097

Signature of
Role Plan administrator
Date 2024-10-09
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL 401(K) PLAN 2022 202768583 2023-06-27 FLORIDA INTERNAL MEDICINE, PL 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 202768583
Plan administrator’s name FLORIDA INTERNAL MEDICINE, PL
Plan administrator’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523650097

Signature of
Role Plan administrator
Date 2023-06-27
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL CASH BALANCE PLAN 2022 202768583 2023-06-27 FLORIDA INTERNAL MEDICINE, PL 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2023-06-27
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL CASH BALANCE PLAN 2022 202768583 2023-06-27 FLORIDA INTERNAL MEDICINE, PL 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2023-06-27
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL CASH BALANCE PLAN 2021 202768583 2022-09-21 FLORIDA INTERNAL MEDICINE, PL 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2022-09-21
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL 401(K) PLAN 2021 202768583 2022-09-21 FLORIDA INTERNAL MEDICINE, PL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 202768583
Plan administrator’s name FLORIDA INTERNAL MEDICINE, PL
Plan administrator’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523650097

Signature of
Role Plan administrator
Date 2022-09-21
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL CASH BALANCE PLAN 2020 202768583 2021-07-22 FLORIDA INTERNAL MEDICINE, PL 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL 401(K) PLAN 2020 202768583 2021-07-22 FLORIDA INTERNAL MEDICINE, PL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 202768583
Plan administrator’s name FLORIDA INTERNAL MEDICINE, PL
Plan administrator’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523650097

Signature of
Role Plan administrator
Date 2021-07-22
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL 401(K) PLAN 2019 202768583 2020-04-25 FLORIDA INTERNAL MEDICINE, PL 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 202768583
Plan administrator’s name FLORIDA INTERNAL MEDICINE, PL
Plan administrator’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523650097

Signature of
Role Plan administrator
Date 2020-04-25
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature
FLORIDA INTERNAL MEDICINE, PL CASH BALANCE PLAN 2019 202768583 2020-04-25 FLORIDA INTERNAL MEDICINE, PL 2
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 3523650097
Plan sponsor’s address 3016 PALERMO COURT, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2020-04-25
Name of individual signing DWARAKNADH BANALA, TRUSTEE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BANALA DWARAKNADH R Agent 3016 PALERMO CT, MOUNT DORA, FL, 34748

Managing Member

Name Role Address
BANALA DWARAKNADH R Managing Member 3016 PALERMO CT, MOUNT DORA, FL, 34748

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-02-04 3016 PALERMO CT, MOUNT DORA, FL 32757 No data
REGISTERED AGENT NAME CHANGED 2011-01-21 BANALA, DWARAKNADH R No data
REGISTERED AGENT ADDRESS CHANGED 2011-01-21 3016 PALERMO CT, MOUNT DORA, FL 34748 No data
CHANGE OF MAILING ADDRESS 2009-04-29 3016 PALERMO CT, MOUNT DORA, FL 32757 No data

Documents

Name Date
ANNUAL REPORT 2025-01-19
ANNUAL REPORT 2024-02-20
ANNUAL REPORT 2023-02-04
ANNUAL REPORT 2022-04-03
ANNUAL REPORT 2021-04-07
ANNUAL REPORT 2020-06-07
ANNUAL REPORT 2019-04-27
ANNUAL REPORT 2018-01-20
ANNUAL REPORT 2017-04-04
ANNUAL REPORT 2016-03-06

Related by officers

BANALA DWARAKNADH R

1305 CLEVELAND, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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