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  5. PRIME HEALTH OF CENTRAL FLORIDA, PLLC

PRIME HEALTH OF CENTRAL FLORIDA, PLLC

Company Details

Entity Name: PRIME HEALTH OF CENTRAL FLORIDA, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 30 May 2019 (6 years ago)
Document Number: L19000144490
FEI/EIN Number 84-2013160
Address: 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701
Mail Address: 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701
ZIP code: 32701
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1902465610 2019-06-07 2022-12-07 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 327016834, US 517 HEALTH BLVD, DAYTONA BEACH, FL, 321141493, US

Contacts
Phone +1 386-271-2273
Fax 3862712274
Phone +1 386-256-4031
Fax 3862567151

Authorized person
Name OSMAN AHMAD
Role EXECUTIVE DIRECTOR
Phone 3212747519

Taxonomy
Taxonomy Code 2080P0206X - Pediatric Gastroenterology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRIME HEALTH OF CENTRAL FLORIDA, PLLC 401(K) PLAN 2023 842013160 2024-05-14 PRIME HEALTH OF CENTRAL FLORIDA, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621900
Sponsor’s telephone number 3212747519
Plan sponsor’s address 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-14
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature
PRIME HEALTH OF CENTRAL FLORIDA, PLLC 401(K) PLAN 2022 842013160 2023-05-27 PRIME HEALTH OF CENTRAL FLORIDA, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621900
Sponsor’s telephone number 3212747519
Plan sponsor’s address 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-05-27
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
PRIME HEALTH OF CENTRAL FLORIDA, PLLC 401(K) PLAN 2021 842013160 2022-06-01 PRIME HEALTH OF CENTRAL FLORIDA, PLLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621900
Sponsor’s telephone number 3212747519
Plan sponsor’s address 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-06-01
Name of individual signing CHRISTINE RIMER
Valid signature Filed with authorized/valid electronic signature
PRIME HEALTH OF CENTRAL FLORIDA, PLLC 401(K) PLAN 2020 842013160 2021-05-03 PRIME HEALTH OF CENTRAL FLORIDA, PLLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621900
Sponsor’s telephone number 3212747519
Plan sponsor’s address 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-05-03
Name of individual signing CAROL HO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
AHMAD OSMAN Agent 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Authorized Member

Name Role Address
AHMAD OSMAN Authorized Member 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701
ABDULLAH BISHER Authorized Member 608 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000068331 ADVANCED PEDIATRIC GASTROENTEROLOGY SPECIALISTS, LLC ACTIVE 2019-06-17 2029-12-31 No data 608 MAITLAND AVENUE, ALTAMONTE SPRINGS, FL, 32701

Documents

Name Date
ANNUAL REPORT 2024-01-22
ANNUAL REPORT 2023-01-09
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-01-09
ANNUAL REPORT 2020-03-17
Florida Limited Liability 2019-05-30

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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