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  5. PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A.

PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A.

Company Details

Entity Name: PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 23 Jun 2004 (21 years ago)
Document Number: P04000096115
FEI/EIN Number 201395801
Address: 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086, US
Mail Address: 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086, US
ZIP code: 32086
County: St. Johns
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PULMONARY ASSOCIATES OF ST. AUGUSTINE RETIREMENT PLAN 2016 201395801 2017-08-21 PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9048248666
Plan sponsor’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086

Signature of
Role Plan administrator
Date 2017-08-21
Name of individual signing JAVIER ADUEN, M.D.
Valid signature Filed with authorized/valid electronic signature
PULMONARY ASSOCIATES OF ST. AUGUSTINE RETIREMENT PLAN 2015 201395801 2016-07-29 PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9048248666
Plan sponsor’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing JAVIER ADUEN, M.D.
Valid signature Filed with authorized/valid electronic signature
PULMONARY ASSOCIATES OF ST. AUGUSTINE RETIREMENT PLAN 2014 201395801 2015-10-09 PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9048248666
Plan sponsor’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing JAVIER ADUEN, M.D.
Valid signature Filed with authorized/valid electronic signature
PULMONARY ASSOCIATES OF ST. AUGUSTINE RETIREMENT PLAN 2013 201395801 2014-05-07 PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9048248666
Plan sponsor’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086

Signature of
Role Plan administrator
Date 2014-05-07
Name of individual signing JAVIER ADUEN, M.D.
Valid signature Filed with authorized/valid electronic signature
PULMONARY ASSOCIATES OF ST. AUGUSTINE RETIREMENT PLAN 2012 201395801 2013-05-17 PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9048248666
Plan sponsor’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086

Signature of
Role Plan administrator
Date 2013-05-17
Name of individual signing JAVIER ADUEN, M.D.
Valid signature Filed with authorized/valid electronic signature
PULMONARY ASSOCIATES OF ST. AUGUSTINE RETIREMENT PLAN 2011 201395801 2012-10-05 PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9048248666
Plan sponsor’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086

Plan administrator’s name and address
Administrator’s EIN 201395801
Plan administrator’s name PULMONARY ASSOCIATES OF ST. AUGUSTINE, P.A.
Plan administrator’s address 300 HEALTH PARK BOULEVARD, STE 4000, ST. AUGUSTINE, FL, 32086
Administrator’s telephone number 9048248666

Signature of
Role Plan administrator
Date 2012-10-05
Name of individual signing JAVIER ADUEN, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Husain Kishwar Agent 300 Health Park Blvd., Suite 4000, St. Augustine, FL, 32286

Director

Name Role Address
HUSAIN KISHWAR Director 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086

President

Name Role Address
HUSAIN KISHWAR President 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086
ADUEN JAVIER President 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086
Usman Faisal President 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086

Secretary

Name Role Address
HUSAIN KISHWAR Secretary 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086

Treasurer

Name Role Address
ADUEN JAVIER Treasurer 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086
Usman Faisal Treasurer 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086

Vice President

Name Role Address
ADUEN JAVIER Vice President 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086
Usman Faisal Vice President 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086

Prac

Name Role Address
Mannino Anna M Prac 300 HEALTH PARK BLVD.,, ST AUGUSTINE, FL, 32086

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-03-15 300 HEALTH PARK BLVD.,, SUITE 4000, ST AUGUSTINE, FL 32086 No data
CHANGE OF MAILING ADDRESS 2021-03-15 300 HEALTH PARK BLVD.,, SUITE 4000, ST AUGUSTINE, FL 32086 No data
REGISTERED AGENT ADDRESS CHANGED 2019-02-07 300 Health Park Blvd., Suite 4000, St. Augustine, FL 32286 No data
REGISTERED AGENT NAME CHANGED 2014-01-21 Husain, Kishwar No data

Documents

Name Date
ANNUAL REPORT 2024-04-01
ANNUAL REPORT 2023-02-10
ANNUAL REPORT 2022-03-08
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-01-09
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-03-21
ANNUAL REPORT 2015-02-27

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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