| Entity Name: | PENINSULA PEDIATRICS OF WEST FLORIDA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PENINSULA PEDIATRICS OF WEST FLORIDA, PLLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 30 Sep 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 13 Oct 2016 (8 years ago) |
| Document Number: | L15000166683 |
| FEI/EIN Number |
81-1183199
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 13163 66th Street N, LARGO, FL, 33773, US |
| Mail Address: | 13163 66th Street N, LARGO, FL, 33773, US |
| ZIP code: | 33773 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639538713 | 2016-02-17 | 2023-06-05 | 13163 66TH STREET, LARGO, FL, 33773, US | 13163 66TH STREET, LARGO, FL, 33773, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 727-228-7000 |
| Fax | 7272233614 |
Authorized person
| Name | DR. STEVEN MICHAEL MOORE |
| Role | OWNER |
| Phone | 7272287000 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME 100692 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 018367100 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PENINSULA PEDIATRICS OF WEST FLORIDA 401(K) PROFIT SHARING PLAN | 2023 | 811183199 | 2024-08-15 | PENINSULA PEDIATRICS OF WEST FLORIDA, PLLC | 10 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-08-15 |
| Name of individual signing | STEVEN MOORE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2022-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7272287000 |
| Plan sponsor’s address | 13131 66TH STREET NORTH, LARGO, FL, 33773 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-05 |
| Name of individual signing | STEVEN MOORE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MOORE STEVEN MMD | Manager | 107 PALMETTO LN, LARGO, FL, 33770 |
| MOORE STEVEN M | Agent | 107 PALMETTO LN, LARGO, FL, 33770 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000007945 | PENINSULA PEDIATRICS | ACTIVE | 2016-01-21 | 2026-12-31 | - | 107 PALMETTO LANE, LARGO, FL, 33770 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-01 | 13163 66th Street N, LARGO, FL 33773 | - |
| CHANGE OF MAILING ADDRESS | 2023-02-01 | 13163 66th Street N, LARGO, FL 33773 | - |
| REINSTATEMENT | 2016-10-13 | - | - |
| REGISTERED AGENT NAME CHANGED | 2016-10-13 | MOORE, STEVEN M | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-05-18 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-05-14 |
| ANNUAL REPORT | 2019-04-21 |
| ANNUAL REPORT | 2018-04-21 |
| ANNUAL REPORT | 2017-03-12 |
| REINSTATEMENT | 2016-10-13 |
| Florida Limited Liability | 2015-09-30 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2863227202 | 2020-04-16 | 0455 | PPP | 13131 66th Street North N/A, LARGO, FL, 33771 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 01 Mar 2025
Sources: Florida Department of State
