| Entity Name: | WASSERMAN PEDIATRICS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Feb 2002 (23 years ago) |
| Date of dissolution: | 18 Apr 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 18 Apr 2016 (9 years ago) |
| Document Number: | P02000014566 |
| FEI/EIN Number | 330993916 |
| Address: | 5844 N ORANGE BLOSSOM TR, ORLANDO, FL, 32810-1025, US |
| Mail Address: | PO Box 848, Ocoee, FL, 34761, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235166166 | 2006-06-27 | 2012-07-11 | 5844 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101025, US | 5844 N ORANGE BLOSSOM TRL, ORLANDO, FL, 328101025, US | |||||||||||||||||||||||||
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| Phone | +1 407-578-2002 |
| Fax | 4075782277 |
Authorized person
| Name | DR. LEWIS C WASSERMAN |
| Role | PRESIDENT |
| Phone | 4075782002 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | ME0053446 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 267539100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WASSERMAN LEWIS | Agent | 1306 CENTURY OAK DR., OCOEE, FL, 34761 |
| Name | Role | Address |
|---|---|---|
| WASSERMAN LEWIS | Director | 1306 CENTURY OAK DR., OCOEE, FL, 34761 |
| WASSERMAN LINDA | Director | 1306 CENTURY OAK DR., OCOEE, FL, 34761 |
| Name | Role | Address |
|---|---|---|
| WASSERMAN LEWIS | President | 1306 CENTURY OAK DR., OCOEE, FL, 34761 |
| Name | Role | Address |
|---|---|---|
| WASSERMAN LINDA | Vice President | 1306 CENTURY OAK DR., OCOEE, FL, 34761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-04-18 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-22 | 5844 N ORANGE BLOSSOM TR, ORLANDO, FL 32810-1025 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-03-21 | WASSERMAN, LEWIS | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-29 | 5844 N ORANGE BLOSSOM TR, ORLANDO, FL 32810-1025 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-01-12 | 1306 CENTURY OAK DR., OCOEE, FL 34761 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2016-04-18 |
| ANNUAL REPORT | 2015-03-22 |
| ANNUAL REPORT | 2014-03-09 |
| ANNUAL REPORT | 2013-04-17 |
| ANNUAL REPORT | 2012-03-21 |
| ANNUAL REPORT | 2011-04-08 |
| ANNUAL REPORT | 2010-03-06 |
| ANNUAL REPORT | 2009-03-10 |
| ANNUAL REPORT | 2008-01-29 |
| ANNUAL REPORT | 2007-01-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
