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NORTH FLORIDA PEDIATRICS, P.A. - Florida Company Profile

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Company Details

Entity Name: NORTH FLORIDA PEDIATRICS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 29 Nov 1995 (30 years ago)
Document Number: P95000090942
FEI/EIN Number 593349350
Address: 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025, US
Mail Address: 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025, US
ZIP code: 32025
City: Lake City
County: Columbia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
SANTELICES SAMUEL M President 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
SANTELICES SAMUEL M Secretary 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
SANTELICES SAMUEL M Director 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
Santelices Samuel Dr. Agent 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

National Provider Identifier

NPI Number:
1396415915
Certification Date:
2021-09-10

Authorized Person:

Name:
SAMUEL SANTELICES
Role:
PRESIDENT/ CEO
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Fax:
3867554432
Fax:
3863391067

Form 5500 Series

Employer Identification Number (EIN):
593349350
Plan Year:
2023
Number Of Participants:
68
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
77
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
90
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
65
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
61
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2016-01-25 Santelices, Samuel, Dr. -
REGISTERED AGENT ADDRESS CHANGED 2011-01-25 1859 SW NEWLAND WAY, LAKE CITY, FL 32025 -
CHANGE OF MAILING ADDRESS 2010-02-19 1859 SW NEWLAND WAY, LAKE CITY, FL 32025 -
CHANGE OF PRINCIPAL ADDRESS 2002-03-07 1859 SW NEWLAND WAY, LAKE CITY, FL 32025 -

Documents

Name Date
ANNUAL REPORT 2025-01-13
ANNUAL REPORT 2024-01-19
ANNUAL REPORT 2023-01-31
ANNUAL REPORT 2022-01-12
ANNUAL REPORT 2021-01-26
ANNUAL REPORT 2020-01-06
ANNUAL REPORT 2019-01-07
ANNUAL REPORT 2018-02-28
ANNUAL REPORT 2017-03-14
ANNUAL REPORT 2016-01-25

OSHA's Inspections within Industry

Inspection Summary

Date:
2012-11-08
Type:
Planned
Address:
1117 NW HWY 41, STE B, JASPER, FL, 32052
Safety Health:
Health
Scope:
Complete

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Date of last update: 01 Aug 2025

Sources: Florida Department of State