| Entity Name: | ORLANDO PEDIATRICS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Nov 2012 (12 years ago) |
| Document Number: | L12000141450 |
| FEI/EIN Number | 46-1348731 |
| Address: | 22 NORTH JOHN YOUNG PARKWAY, KISSIMMEE, FL 34741 |
| Mail Address: | 22 NORTH JOHN YOUNG PARKWAY, KISSIMMEE, FL 34741 |
| ZIP code: | 34741 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740527142 | 2013-01-07 | 2013-01-07 | PO BOX 770458, ORLANDO, FL, 328770458, US | 800 N ROSE AVE, SUITE 800, KISSIMMEE, FL, 347414944, US | |||||||||||||||||||||||||
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| Phone | +1 407-361-5123 |
| Phone | +1 407-483-7925 |
| Fax | 4074837924 |
Authorized person
| Name | SAMIER KHAZNADAR |
| Role | PHYSICAN |
| Phone | 4074837925 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 263337000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KHAZNADAR, SAMER | Agent | 12605 NEWFIELD DRIVE, ORLANDO, FL 32837 |
| Name | Role | Address |
|---|---|---|
| KHAZNADAR, SAMER | Managing Member | 800 N. ROSE AVE, KISSIMMEE, FL 34741 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-13 | 22 NORTH JOHN YOUNG PARKWAY, KISSIMMEE, FL 34741 | No data |
| CHANGE OF MAILING ADDRESS | 2020-01-13 | 22 NORTH JOHN YOUNG PARKWAY, KISSIMMEE, FL 34741 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-02-22 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-04-17 |
| ANNUAL REPORT | 2020-06-10 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-04-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2269647403 | 2020-05-05 | 0455 | PPP | 22 N John Young Parkway, Kissimmee, FL, 34741 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 22 Feb 2025
Sources: Florida Department of State
