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  5. NEW LUNG ASSOCIATES, PA.

NEW LUNG ASSOCIATES, PA.

Company Details

Entity Name: NEW LUNG ASSOCIATES, PA.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 27 Nov 2006 (18 years ago)
Date of dissolution: 10 Mar 2017 (8 years ago)
Last Event: VOLUNTARY DISS W/ NOTICE
Event Date Filed: 10 Mar 2017 (8 years ago)
Document Number: P06000147972
FEI/EIN Number 205982558
Address: NEW LUNG ASSOCIATES PA, 5 TAMPA GENERAL CIRCLE 730, TAMPA, FL, 33606
Mail Address: 16323 BURNISTON DR., TAMPA, FL, 33647
ZIP code: 33606
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992861785 2006-12-28 2009-12-10 16057 TAMPA PALMS BLVD W, BOX 409, TAMPA, FL, 336472001, US 5 TAMPA GENERAL CIRCLE, HARBORSIDE TOWERS, SUITE 450, TAMPA, FL, 336063589, US

Contacts
Phone +1 813-844-4634
Fax 8136311737

Authorized person
Name DR. MARK W. ROLFE
Role PRESIDENT
Phone 81238444634

Taxonomy
Taxonomy Code 207RP1001X - Pulmonary Disease Physician
License Number ME62408
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 279353900
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEW LUNG ASSOCIATES, PA DEFINED BENEFIT PLAN 2011 205982558 2012-09-27 NEW LUNG ASSOCIATES, PA 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8133901629
Plan sponsor’s address 16323 BURNISTON DRIVE, TAMPA, FL, 33647

Plan administrator’s name and address
Administrator’s EIN 205982558
Plan administrator’s name NEW LUNG ASSOCIATES, PA
Plan administrator’s address 16323 BURNISTON DRIVE, TAMPA, FL, 33647
Administrator’s telephone number 8133901629

Signature of
Role Plan administrator
Date 2012-09-27
Name of individual signing MARK W. ROLFE
Valid signature Filed with authorized/valid electronic signature
NEW LUNG ASSOCIATES, PA 401K PLAN 2011 205982558 2012-08-02 NEW LUNG ASSOCIATES, PA 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 812990
Sponsor’s telephone number 8633901629
Plan sponsor’s address 16323 BRINTON AVENUE, TAMPA, FL, 33647

Plan administrator’s name and address
Administrator’s EIN 205982558
Plan administrator’s name NEW LUNG ASSOCIATES, PA
Plan administrator’s address 16323 BRINTON AVENUE, TAMPA, FL, 33647
Administrator’s telephone number 8633901629

Signature of
Role Plan administrator
Date 2012-08-02
Name of individual signing MARK W. ROLFE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-02
Name of individual signing DR. TARIK HADDAD
Valid signature Filed with authorized/valid electronic signature
NEW LUNG ASSOCIATES, PA 401K PLAN 2011 205982558 2012-07-24 NEW LUNG ASSOCIATES, PA 2
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 812990
Sponsor’s telephone number 8633901629
Plan sponsor’s address 16323 BRINTON AVENUE, TAMPA, FL, 33647

Plan administrator’s name and address
Administrator’s EIN 205982558
Plan administrator’s name NEW LUNG ASSOCIATES, PA
Plan administrator’s address 16323 BRINTON AVENUE, TAMPA, FL, 33647
Administrator’s telephone number 8633901629

Signature of
Role Plan administrator
Date 2012-07-24
Name of individual signing MARK W. ROLFE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-24
Name of individual signing DR. TARIK HADDAD
Valid signature Filed with authorized/valid electronic signature
NEW LUNG ASSOCIATES, PA 401K PLAN 2010 205982558 2011-09-27 NEW LUNG ASSOCIATES, PA 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 812990
Sponsor’s telephone number 8633901629
Plan sponsor’s address 16323 BRINTON AVENUE, TAMPA, FL, 33647

Plan administrator’s name and address
Administrator’s EIN 205982558
Plan administrator’s name NEW LUNG ASSOCIATES, PA
Plan administrator’s address 16323 BRINTON AVENUE, TAMPA, FL, 33647
Administrator’s telephone number 8633901629

Signature of
Role Plan administrator
Date 2011-09-27
Name of individual signing MARK W. ROLFE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-27
Name of individual signing DR. TARIK HADDAD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
DUNSFORD & ASSOCIATES, PA Agent

Director

Name Role Address
ROLFE MARK W. M Director 16323 BURNISTON DR., TAMPA, FL, 33647

Events

Event Type Filed Date Value Description
VOLUNTARY DISS W/ NOTICE 2017-03-10 No data No data
CHANGE OF PRINCIPAL ADDRESS 2012-02-11 NEW LUNG ASSOCIATES PA, 5 TAMPA GENERAL CIRCLE 730, TAMPA, FL 33606 No data

Documents

Name Date
CORAPVDWN 2017-03-10
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-02-22
ANNUAL REPORT 2014-01-10
ANNUAL REPORT 2013-01-28
ANNUAL REPORT 2012-02-11
ANNUAL REPORT 2011-01-16
ANNUAL REPORT 2010-01-09
ANNUAL REPORT 2009-01-17
ANNUAL REPORT 2008-01-13

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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