Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Orange
    4. ›
  4. 32835
    5. ›
  5. SOUTH LAKE PEDIATRICS, P.A.

SOUTH LAKE PEDIATRICS, P.A. - Florida Company Profile

Company Details

Entity Name: SOUTH LAKE PEDIATRICS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

SOUTH LAKE PEDIATRICS, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 26 Oct 2000 (25 years ago)
Date of dissolution: 31 Jan 2022 (3 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 31 Jan 2022 (3 years ago)
Document Number: P00000101069
FEI/EIN Number 593677418

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: SOUTH LAKE PEDIATRICS, P.A., 8048 Horse Ferry Road, Orlando, FL, 32835, US
Mail Address: SOUTH LAKE PEDIATRICS, P.A., 8048 Horse Ferry Road, Orlando, FL, 32835, US
ZIP code: 32835
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1699076901 2010-11-03 2010-11-03 3155 CITRUS TOWER BLVD, BLDG.# 1, CLERMONT, FL, 347116803, US 3155 CITRUS TOWER BLVD, BLDG.# 1, CLERMONT, FL, 347116803, US

Contacts
Phone +1 352-242-1500
Fax 3522420053

Authorized person
Name DR. ADINARAYANAMURTHY NALLAMSHETTY
Role PRESIDENT
Phone 3522421500

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
License Number ME073750
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 260240700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2016 593677418 2017-04-20 SOUTH LAKE PEDIATRICS, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2017-04-19
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-19
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2016 593677418 2017-11-15 SOUTH LAKE PEDIATRICS, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2015 593677418 2016-08-11 SOUTH LAKE PEDIATRICS, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., #1, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2016-08-11
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-11
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2014 593677418 2015-06-24 SOUTH LAKE PEDIATRICS, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2015-06-18
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-18
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2013 593677418 2014-07-03 SOUTH LAKE PEDIATRICS, P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2014-07-02
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-02
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2012 593677418 2013-07-19 SOUTH LAKE PEDIATRICS, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Signature of
Role Plan administrator
Date 2013-07-18
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-18
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2011 593677418 2012-07-31 SOUTH LAKE PEDIATRICS, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593677418
Plan administrator’s name SOUTH LAKE PEDIATRICS, P.A.
Plan administrator’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711
Administrator’s telephone number 3522421500

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing ADINARAYANAMURTHY V NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-31
Name of individual signing ADINARAYANAMURTHY V NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2010 593677418 2011-09-20 SOUTH LAKE PEDIATRICS, P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593677418
Plan administrator’s name SOUTH LAKE PEDIATRICS, P.A.
Plan administrator’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711
Administrator’s telephone number 3522421500

Signature of
Role Plan administrator
Date 2011-09-19
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-19
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2010 593677418 2011-06-20 SOUTH LAKE PEDIATRICS, P.A. 10
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593677418
Plan administrator’s name SOUTH LAKE PEDIATRICS, P.A.
Plan administrator’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711
Administrator’s telephone number 3522421500

Signature of
Role Plan administrator
Date 2011-06-19
Name of individual signing ADINARAYANAMURTHY NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-19
Name of individual signing ADINARAYANAMURTHY NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
SOUTH LAKE PEDIATRICS, P.A. RETIREMENT AND SAVINGS PLAN 2009 593677418 2010-07-16 SOUTH LAKE PEDIATRICS, P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3522421500
Plan sponsor’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711

Plan administrator’s name and address
Administrator’s EIN 593677418
Plan administrator’s name SOUTH LAKE PEDIATRICS, P.A.
Plan administrator’s address 3155 CITRUS TOWER BLVD., BLDG 1, CLERMONT, FL, 34711
Administrator’s telephone number 3522421500

Signature of
Role Plan administrator
Date 2010-07-16
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-16
Name of individual signing ADI NALLAMSHETTY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
NALLAMSHETTY ADINARAYANAMUR Director 8048 Horse Ferry Road, Orlando, FL, 32835
NALLAMSHETTY ADINARAYANAMUR Agent 8048 Horse Ferry Road, Orlando, FL, 32835

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2022-01-31 - -
CHANGE OF PRINCIPAL ADDRESS 2021-01-12 SOUTH LAKE PEDIATRICS, P.A., 8048 Horse Ferry Road, Orlando, FL 32835 -
REGISTERED AGENT ADDRESS CHANGED 2021-01-12 8048 Horse Ferry Road, Orlando, FL 32835 -
CHANGE OF MAILING ADDRESS 2020-01-30 SOUTH LAKE PEDIATRICS, P.A., 8048 Horse Ferry Road, Orlando, FL 32835 -

Documents

Name Date
VOLUNTARY DISSOLUTION 2022-01-31
ANNUAL REPORT 2021-01-12
ANNUAL REPORT 2020-01-30
ANNUAL REPORT 2019-01-28
ANNUAL REPORT 2018-01-12
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-03-04
ANNUAL REPORT 2015-01-13
ANNUAL REPORT 2014-01-19
ANNUAL REPORT 2013-05-16

Companies related by officers

NALLAMSHETTY ADINARAYANAMUR

DHANADI SAI REALTY, LLC - Inactive
Florida Limited Liability Co. (2005 - 2017)
DHANADI SAI REALTY, LLC - Inactive
Florida Limited Liability Co. (2005 - 2017)
SAIRAM REALTY, LLC - Active
Florida Limited Liability Co. (2010 )
SAIRAM REALTY, LLC - Active
Florida Limited Liability Co. (2010 )

Companies related by address

No other companies in our directory share the same address as SOUTH LAKE PEDIATRICS, P.A.

Date of last update: 03 Apr 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated