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  5. FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC.

FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC.

Company Details

Entity Name: FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 22 Jan 2004 (21 years ago)
Document Number: P04000016009
FEI/EIN Number 200690634
Mail Address: 151 LAKE RD, TAVERNIER, FL, 33070, US
Address: 91550 OVERSEAS HIGHWAY, SUITE 209, TAVERNIER, FL, 33070
ZIP code: 33070
County: Monroe
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1033268735 2007-01-10 2020-08-22 91550 OVERSEAS HIGHWAY, SUITE 209, TAVERNIER, FL, 33070, US 91550 OVERSEAS HWY, SUITE 209, TAVERNIER, FL, 330702506, US

Contacts
Phone +1 305-853-0558
Fax 3058530744

Authorized person
Name DR. STANLEY MARTIN ZUBA
Role PRESIDENT
Phone 3058530558

Taxonomy
Taxonomy Code 261Q00000X - Clinic/Center
License Number ME72754
State FL
Is Primary Yes

Other Provider Identifiers
Issuer NPI NUMBER
Number 10724535
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2023 200690634 2024-10-14 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing ERIC A . ANDERSON
Valid signature Filed with authorized/valid electronic signature
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2022 200690634 2023-10-13 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing ERIC A ANDERSON
Valid signature Filed with authorized/valid electronic signature
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2021 200690634 2022-09-14 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070

Signature of
Role Plan administrator
Date 2022-09-14
Name of individual signing ERIC A ANDERSON
Valid signature Filed with authorized/valid electronic signature
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2020 200690634 2021-05-04 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070

Signature of
Role Plan administrator
Date 2021-05-04
Name of individual signing ERIC A ANDERSON
Valid signature Filed with authorized/valid electronic signature
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2019 200690634 2020-09-21 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2018 200690634 2019-09-27 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2017 200690634 2018-07-16 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2016 200690634 2017-10-09 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HWY SUITE 209, TAVERNIER, FL, 33070
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2015 200690634 2016-10-07 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HIGHWAY, TAVERNIER, FL, 33070
FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 401(K) PROFIT SHARING PLAN 2014 200690634 2015-10-13 FLORIDA KEYS PEDIATRIC & ADOLESCENT CENTER, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-03-01
Business code 621111
Sponsor’s telephone number 3058530558
Plan sponsor’s address 91550 OVERSEAS HIGHWAY, TAVERNIER, FL, 33070

Agent

Name Role Address
ZUBA STANLEY M Agent 151 LAKE RD, TAVERNIER, FL, 33070

Dr

Name Role Address
ZUBA STANLEY M Dr 151 LAKE RD, TAVERNIER, FL, 33070

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2013-02-01 91550 OVERSEAS HIGHWAY, SUITE 209, TAVERNIER, FL 33070 No data
REGISTERED AGENT ADDRESS CHANGED 2013-02-01 151 LAKE RD, TAVERNIER, FL 33070 No data
CHANGE OF PRINCIPAL ADDRESS 2006-01-08 91550 OVERSEAS HIGHWAY, SUITE 209, TAVERNIER, FL 33070 No data

Documents

Name Date
ANNUAL REPORT 2025-01-28
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-01-29
ANNUAL REPORT 2022-01-31
ANNUAL REPORT 2021-03-16
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-04-18
ANNUAL REPORT 2018-04-06
ANNUAL REPORT 2017-03-31
ANNUAL REPORT 2016-04-25

Related by officers

ZUBA STANLEY M

1119 CATHERINE ST, LLC GARDENIA STREET, LLC BLUE WATER COMPUTER CONSULTING, INC.

Related by address

151 LAKE RD, TAVERNIER, FL, 33070, US

1119 CATHERINE ST, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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