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  5. NEW INTERLACHEN PEDIATRICS, P.A.

NEW INTERLACHEN PEDIATRICS, P.A.

Company Details

Entity Name: NEW INTERLACHEN PEDIATRICS, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 26 Jan 1999 (26 years ago)
Document Number: P99000007995
FEI/EIN Number 593547951
Address: 846 LAKE HOWELL RD., MAITLAND, FL, 32751, US
Mail Address: 846 LAKE HOWELL RD., MAITLAND, FL, 32751, US
ZIP code: 32751
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1659380459 2006-08-08 2018-10-09 846 LAKE HOWELL RD, MAITLAND, FL, 327515222, US 846 LAKE HOWELL RD, MAITLAND, FL, 327515222, US

Contacts
Phone +1 407-767-2477
Fax 4078349822

Authorized person
Name MR. LUIS SALAZAR
Role PRACTICE ADMINISTRATOR
Phone 4077672477

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2023 593547951 2024-06-12 NEW INTERLACHEN PEDIATRICS, P.A. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2022 593547951 2023-05-08 NEW INTERLACHEN PEDIATRICS, P.A. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2021 593547951 2022-04-19 NEW INTERLACHEN PEDIATRICS, P.A. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2020 593547951 2021-03-09 NEW INTERLACHEN PEDIATRICS, P.A. 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2019 593547951 2020-05-18 NEW INTERLACHEN PEDIATRICS, P.A. 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2018 593547951 2019-05-14 NEW INTERLACHEN PEDIATRICS, P.A. 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2017 593547951 2018-05-15 NEW INTERLACHEN PEDIATRICS, P.A. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2016 593547951 2017-07-11 NEW INTERLACHEN PEDIATRICS, P.A. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751

Signature of
Role Plan administrator
Date 2017-07-11
Name of individual signing JULIE A. WARD, D.O.
Valid signature Filed with authorized/valid electronic signature
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2015 593547951 2016-06-21 NEW INTERLACHEN PEDIATRICS, P.A. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751

Signature of
Role Plan administrator
Date 2016-06-21
Name of individual signing JULIE A. WARD, D.O.
Valid signature Filed with authorized/valid electronic signature
NEW INTERLACHEN PEDIATRICS, P.A. PROFIT SHARING AND 401K PLAN 2014 593547951 2015-05-21 NEW INTERLACHEN PEDIATRICS, P.A. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 846 LAKE HOWELL ROAD, MAITLAND, FL, 32751

Signature of
Role Plan administrator
Date 2015-05-21
Name of individual signing BRENDA B. HOLSON, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
WHWW, INC. Agent

Secretary

Name Role Address
SMITH SAMUEL NDr. Secretary 846 LAKE HOWELL RD., MAITLAND, FL, 32751

President

Name Role Address
WARD JULIE ADr. President 846 LAKE HOWELL RD., MAITLAND, FL, 32751

Vice President

Name Role Address
AGUILAR EMILY MDr. Vice President 846 LAKE HOWELL RD., MAITLAND, FL, 32751
Roitman Gabriela Dr. Vice President 846 Lake Howell Road, Maitland, FL, 32751
Dyer Sareh SDr. Vice President 846 LAKE HOWELL RD., MAITLAND, FL, 32751
Emmert Melanie NDr. Vice President 846 Lake Howell Rd, Maitland, FL, 32751

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G03058700083 INTERLACHEN PEDIATRICS ACTIVE 2003-02-27 2028-12-31 No data 846 LAKE HOWELL RD, MAITLAND, FL, 32751

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-11-07 WHWW, INC. No data
REGISTERED AGENT ADDRESS CHANGED 2023-11-07 329 PARK AVE NORTH, SECOND FLOOR, WINTER PARK, FL 32789 No data
CHANGE OF PRINCIPAL ADDRESS 2011-01-04 846 LAKE HOWELL RD., MAITLAND, FL 32751 No data
CHANGE OF MAILING ADDRESS 2011-01-04 846 LAKE HOWELL RD., MAITLAND, FL 32751 No data

Documents

Name Date
ANNUAL REPORT 2024-01-12
Reg. Agent Change 2023-11-07
AMENDED ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2023-01-24
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-01-29
ANNUAL REPORT 2020-01-02
ANNUAL REPORT 2019-01-02
ANNUAL REPORT 2018-01-11
ANNUAL REPORT 2017-02-21

Related by officers

SMITH SAMUEL NDr.

CASSELBERRY PEDIATRICS, LLC

WARD JULIE ADr.

CASSELBERRY PEDIATRICS, LLC

AGUILAR EMILY MDr.

CASSELBERRY PEDIATRICS, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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