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SIVA MD PA

Company Details

Entity Name: SIVA MD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 29 Aug 2006 (18 years ago)
Document Number: P06000112035
FEI/EIN Number 205459949
Address: 2845 SE 3RD CT, OCALA, FL, 34471, US
Mail Address: 2845 SE 3RD CT, OCALA, FL, 34471
ZIP code: 34471
County: Marion
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003912338 2006-09-15 2010-10-14 2845 SE 3RD CT, OCALA, FL, 34471, US 2845 SE 3RD CT, OCALA, FL, 34471, US

Contacts

Phone +1 352-369-5300
Fax 3523695309

Authorized person

Name DR. RATNASABAPATHY SIVASEKARAN
Role OWNER
Phone 3523695300

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number ME90344
State FL
Is Primary Yes

Other Provider Identifiers

Issuer BCBS
Number 000WQ
State FL
Issuer MEDICAID
Number 270559100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SIVA M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2016 205459949 2017-10-02 SIVA MD PA 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3528958622
Plan sponsor’s address 2845 SE 3RD CT., OCALA, FL, 34471
SIVA M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2015 205459949 2016-08-02 SIVA MD PA 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3528958622
Plan sponsor’s address 2845 SE 3RD CT., OCALA, FL, 34471
SIVA M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2014 205459949 2015-06-19 SIVA MD PA 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3528958622
Plan sponsor’s address 2845 SE 3RD CT., OCALA, FL, 34471
SIVA MD PA 401(K) PROFIT SHARING PLAN & TRUST 2013 205459949 2014-10-07 SIVA MD PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3528958622
Plan sponsor’s address 2845 SE 3RD CT., OCALA, FL, 34471
SIVA MD PA 401 K PROFIT SHARING PLAN TRUST 2012 205459949 2013-07-31 SIVA MD PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 3528611003
Plan sponsor’s address 4938 SE 4TH AVE, OCALA, FL, 344804763

Signature of

Role Plan administrator
Date 2013-07-31
Name of individual signing SIVA MD PA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SIVASEKARAN RATNASABAPATHY Agent 2845 SE 3RD CT, OCALA, FL, 34471

President

Name Role Address
Sivasekaran Ratnasabapathy President 2845 SE 3RD CT, OCALA, FL, 34471

Secretary

Name Role Address
Sivasekaran Ratnasabapathy Secretary 2845 SE 3RD CT, OCALA, FL, 34471

Treasurer

Name Role Address
Sivasekaran Ratnasabapathy Treasurer 2845 SE 3RD CT, OCALA, FL, 34471

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-01-22 2845 SE 3RD CT, OCALA, FL 34471 No data
CHANGE OF PRINCIPAL ADDRESS 2018-02-28 2845 SE 3RD CT, OCALA, FL 34471 No data
CHANGE OF MAILING ADDRESS 2010-03-10 2845 SE 3RD CT, OCALA, FL 34471 No data

Documents

Name Date
ANNUAL REPORT 2024-02-19
ANNUAL REPORT 2023-03-01
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-22
ANNUAL REPORT 2020-01-21
ANNUAL REPORT 2019-02-19
ANNUAL REPORT 2018-02-28
ANNUAL REPORT 2017-01-06
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-01-07

Date of last update: 02 Feb 2025

Sources: Florida Department of State