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  5. THE LUNG CLINIC, P.A.

THE LUNG CLINIC, P.A.

Company Details

Entity Name: THE LUNG CLINIC, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 01 May 1996 (29 years ago)
Date of dissolution: 27 Sep 2017 (7 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 27 Sep 2017 (7 years ago)
Document Number: P96000039032
FEI/EIN Number 59-3375139
Address: 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741
Mail Address: 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741
ZIP code: 34741
County: Osceola
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639196728 2006-07-16 2016-02-24 1115 N CENTRAL AVE, KISSIMMEE, FL, 347414405, US 1115 N CENTRAL AVE, KISSIMMEE, FL, 347414405, US

Contacts
Phone +1 407-944-3500
Fax 4079443503

Authorized person
Name DR. MUHAMMAD K SHAUKAT
Role OWNER
Phone 4079443500

Taxonomy
Taxonomy Code 207RP1001X - Pulmonary Disease Physician
License Number ME49612
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 370115800
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2018 593375139 2019-10-15 LUNG CLINIC, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2017 593375139 2018-10-13 LUNG CLINIC, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2018-10-13
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-13
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2016 593375139 2017-10-16 LUNG CLINIC, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2015 593375139 2016-10-04 LUNG CLINIC, P.A. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2016-10-04
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2014 593375139 2016-08-13 LUNG CLINIC, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2016-08-13
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2014 593375139 2015-05-21 LUNG CLINIC, P.A. 19
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2015-05-21
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2013 593375139 2014-05-28 LUNG CLINIC, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2014-05-28
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2012 593375139 2013-09-05 LUNG CLINIC, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Signature of
Role Plan administrator
Date 2013-09-05
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2011 593375139 2012-05-30 THE LUNG CLINIC, P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Plan administrator’s name and address
Administrator’s EIN 593375139
Plan administrator’s name THE LUNG CLINIC, P.A.
Plan administrator’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741
Administrator’s telephone number 4075995900

Signature of
Role Plan administrator
Date 2012-05-30
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature
THE LUNG CLINIC, P.A. PROFIT SHARING AND 401K PLAN 2010 593375139 2011-06-09 THE LUNG CLINIC, P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-19
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741

Plan administrator’s name and address
Administrator’s EIN 593375139
Plan administrator’s name THE LUNG CLINIC, P.A.
Plan administrator’s address 1115 NORTH CENTRAL AVENUE, KISSIMMEE, FL, 34741
Administrator’s telephone number 4075995900

Signature of
Role Plan administrator
Date 2011-06-09
Name of individual signing MUHAMMAD K. SHAUKAT, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHAUKAT, MUHAMMAD K. Agent 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741

President

Name Role Address
SHAUKAT, MUHAMMAD K. President 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2017-09-27 No data No data
REGISTERED AGENT NAME CHANGED 2017-04-07 SHAUKAT, MUHAMMAD K. No data
CHANGE OF PRINCIPAL ADDRESS 2007-01-26 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741 No data
CHANGE OF MAILING ADDRESS 2007-01-26 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741 No data
REGISTERED AGENT ADDRESS CHANGED 2007-01-26 1115 NORTH CENTRAL AVE, KISSIMMEE, FL 34741 No data
REINSTATEMENT 2001-10-18 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2001-09-21 No data No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2017-09-27
ANNUAL REPORT 2017-04-07
ANNUAL REPORT 2016-05-09
ANNUAL REPORT 2015-03-04
ANNUAL REPORT 2014-03-21
ANNUAL REPORT 2013-02-01
ANNUAL REPORT 2012-02-03
ANNUAL REPORT 2011-02-14
ANNUAL REPORT 2010-02-25
ANNUAL REPORT 2009-03-24

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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