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  5. NORTH FLORIDA PEDIATRICS, P.A.

NORTH FLORIDA PEDIATRICS, P.A.

Company Details

Entity Name: NORTH FLORIDA PEDIATRICS, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 29 Nov 1995 (29 years ago)
Document Number: P95000090942
FEI/EIN Number 59-3349350
Address: 1859 SW NEWLAND WAY, LAKE CITY, FL 32025
Mail Address: 1859 SW NEWLAND WAY, LAKE CITY, FL 32025
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2014 593349350 2015-10-09 NORTH FLORIDA PEDIATRICS, P.A. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3867580003
Plan sponsor’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing DR. SAMUEL SANTELICES
Valid signature Filed with authorized/valid electronic signature
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2013 593349350 2014-07-25 NORTH FLORIDA PEDIATRICS, P.A. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3867580003
Plan sponsor’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2014-07-25
Name of individual signing DR. SAMUEL SANTELICES
Valid signature Filed with authorized/valid electronic signature
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2012 593349350 2013-07-28 NORTH FLORIDA PEDIATRICS, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3867580003
Plan sponsor’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

Plan administrator’s name and address
Administrator’s EIN 593349350
Plan administrator’s name NORTH FLORIDA PEDIATRICS, P.A.
Plan administrator’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
Administrator’s telephone number 3867580003

Signature of
Role Plan administrator
Date 2013-07-28
Name of individual signing DR. SAMUEL SANTELICES
Valid signature Filed with authorized/valid electronic signature
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2011 593349350 2012-10-15 NORTH FLORIDA PEDIATRICS, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3867580003
Plan sponsor’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

Plan administrator’s name and address
Administrator’s EIN 593349350
Plan administrator’s name NORTH FLORIDA PEDIATRICS, P.A.
Plan administrator’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
Administrator’s telephone number 3867580003

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing DR. SAMUEL SANTELICES
Valid signature Filed with authorized/valid electronic signature
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2010 593349350 2011-10-17 NORTH FLORIDA PEDIATRICS, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3867580003
Plan sponsor’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

Plan administrator’s name and address
Administrator’s EIN 593349350
Plan administrator’s name NORTH FLORIDA PEDIATRICS, P.A.
Plan administrator’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
Administrator’s telephone number 3867580003

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing DR. SAMUEL SANTELICES
Valid signature Filed with authorized/valid electronic signature
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2010 593349350 2011-10-14 NORTH FLORIDA PEDIATRICS, P.A. 26
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3867580003
Plan sponsor’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025

Plan administrator’s name and address
Administrator’s EIN 593349350
Plan administrator’s name NORTH FLORIDA PEDIATRICS, P.A.
Plan administrator’s address 1859 SW NEWLAND WAY, LAKE CITY, FL, 32025
Administrator’s telephone number 3867580003

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing DR. SAMUEL SANTELICES
Valid signature Filed with incorrect/unrecognized electronic signature
NORTH FLORIDA PEDIATRICS, P.A. PROFIT SHARING AND 401(K) PLAN 2009 593349350 2010-08-02 NORTH FLORIDA PEDIATRICS, P.A. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 3523736362
Plan sponsor’s address 7205 N.W. 47TH COURT, GAINESVILLE, FL, 32606

Plan administrator’s name and address
Administrator’s EIN 593349350
Plan administrator’s name NORTH FLORIDA PEDIATRICS, P.A.
Plan administrator’s address 7205 N.W. 47TH COURT, GAINESVILLE, FL, 32606
Administrator’s telephone number 3523736362

Signature of
Role Plan administrator
Date 2010-08-02
Name of individual signing FREDERICK THOMAS WEBER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-02
Name of individual signing FREDERICK THOMAS WEBER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Santelices, Samuel, Dr. Agent 1859 SW NEWLAND WAY, LAKE CITY, FL 32025

President

Name Role Address
SANTELICES, SAMUEL M.D. President 1859 SW NEWLAND WAY, LAKE CITY, FL 32025

Secretary

Name Role Address
SANTELICES, SAMUEL M.D. Secretary 1859 SW NEWLAND WAY, LAKE CITY, FL 32025

Director

Name Role Address
SANTELICES, SAMUEL M.D. Director 1859 SW NEWLAND WAY, LAKE CITY, FL 32025

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2016-01-25 Santelices, Samuel, Dr. No data
REGISTERED AGENT ADDRESS CHANGED 2011-01-25 1859 SW NEWLAND WAY, LAKE CITY, FL 32025 No data
CHANGE OF MAILING ADDRESS 2010-02-19 1859 SW NEWLAND WAY, LAKE CITY, FL 32025 No data
CHANGE OF PRINCIPAL ADDRESS 2002-03-07 1859 SW NEWLAND WAY, LAKE CITY, FL 32025 No data

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

Related by officers

No related officers

Related by address

1859 SW NEWLAND WAY, LAKE CITY, FL 32025

NORTH FLORIDA PEDIATRICS JACKSONVILLE, PA

1859 SW NEWLAND WAY, LAKE CITY, FL 32025

NORTH FLORIDA PEDIATRICS JACKSONVILLE, PA

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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