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PREMIER PEDIATRICS LLC

Company Details

Entity Name: PREMIER PEDIATRICS LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 21 Dec 2006 (18 years ago)
Document Number: L06000121393
FEI/EIN Number 20-8107976
Address: 7960 SW 60TH AVE, OCALA, FL 34476
Mail Address: 7960 SW 60TH AVE, OCALA, FL 34476
ZIP code: 34476
County: Marion
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639740624 2021-07-09 2023-01-20 7960 SW 60TH AVE STE 100, OCALA, FL, 344766457, US 14141 E HIGHWAY 40, SILVER SPRINGS, FL, 344883910, US

Contacts

Phone +1 352-671-6741
Fax 3526716742
Phone +1 352-512-0466
Fax 3525120374

Authorized person

Name MR. SHAHAB EUNUS
Role CEO
Phone 3526716741

Taxonomy

Taxonomy Code 208000000X - Pediatrics Physician
Is Primary No
Taxonomy Code 261QP2300X - Primary Care Clinic/Center
Is Primary No
Taxonomy Code 261QR1300X - Rural Health Clinic/Center
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 111314300
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER PEDIATRICS LLC 401(K) PLAN 2023 208107976 2024-05-28 PREMIER PEDIATRICS LLC 106
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2024-05-28
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS LLC 401(K) PLAN 2022 208107976 2023-06-16 PREMIER PEDIATRICS LLC 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2023-06-16
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS LLC 401(K) PLAN 2021 208107976 2022-07-05 PREMIER PEDIATRICS LLC 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2022-07-05
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS LLC 401(K) PLAN 2020 208107976 2021-06-15 PREMIER PEDIATRICS LLC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2021-06-15
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS LLC 401(K) PLAN 2019 208107976 2020-07-17 PREMIER PEDIATRICS LLC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2020-07-17
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS LLC 401(K) PLAN 2018 208107976 2019-06-06 PREMIER PEDIATRICS LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2019-06-06
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS, LLC 401(K) PROFIT SHARING PLAN 2017 208107976 2018-08-02 PREMIER PEDIATRICS, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2018-08-02
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS, LLC 401(K) PROFIT SHARING PLAN 2016 208107976 2017-10-03 PREMIER PEDIATRICS, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Signature of

Role Plan administrator
Date 2017-10-03
Name of individual signing FARID EUNUS
Valid signature Filed with authorized/valid electronic signature
PREMIER PEDIATRICS, LLC DEFINED BENEFIT PLAN 2016 208107976 2017-03-21 PREMIER PEDIATRICS, LLC 20
Three-digit plan number (PN) 002
Effective date of plan 2011-02-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476
PREMIER PEDIATRICS, LLC DEFINED BENEFIT PLAN 2016 208107976 2017-05-17 PREMIER PEDIATRICS, LLC 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-02-01
Business code 621111
Sponsor’s telephone number 3526716741
Plan sponsor’s address 7960 SW 60TH AVE, OCALA, FL, 34476

Agent

Name Role Address
EUNUS, SHAHAB Agent 1850 SW 40TH PL, OCALA, FL 34471

Managing Member

Name Role Address
EUNUS, SHAHAB Managing Member 1850 SW 40TH PL, OCALA, FL 34471

Manager

Name Role Address
Rogozina, Svetlana Y Manager 1850 SW 40th PL, OCALA, FL 34471

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000090422 PREMIER PEDIATRICS AND FAMILY PRACTICE EXPIRED 2014-09-04 2019-12-31 No data 7960 SW 60TH AVE, OCALA, FL, 34476

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2016-03-08 1850 SW 40TH PL, OCALA, FL 34471 No data
CHANGE OF PRINCIPAL ADDRESS 2011-01-05 7960 SW 60TH AVE, OCALA, FL 34476 No data
CHANGE OF MAILING ADDRESS 2011-01-05 7960 SW 60TH AVE, OCALA, FL 34476 No data

Documents

Name Date
ANNUAL REPORT 2024-04-08
ANNUAL REPORT 2023-03-10
ANNUAL REPORT 2022-01-03
ANNUAL REPORT 2021-04-10
ANNUAL REPORT 2020-03-14
ANNUAL REPORT 2019-03-29
ANNUAL REPORT 2018-03-01
ANNUAL REPORT 2017-04-17
ANNUAL REPORT 2016-03-08
ANNUAL REPORT 2015-01-13

Date of last update: 27 Jan 2025

Sources: Florida Department of State