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  5. RAJARAM, P.A.

RAJARAM, P.A.

Company Details

Entity Name: RAJARAM, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 14 Oct 1999 (25 years ago)
Date of dissolution: 23 Sep 2016 (8 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2016 (8 years ago)
Document Number: P99000090711
FEI/EIN Number 593602551
Address: 40124 US HWY 27, SUITE 203, DAVENPORT, FL, 33837
Mail Address: 40124 US HWY 27, SUITE 203, DAVENPORT, FL, 33837
ZIP code: 33837
County: Polk
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1891991832 2007-06-26 2007-08-02 321 E ROBERTSON ST, BRANDON, FL, 335115253, US 40124 HIGHWAY 27, SUITE 203, DAVENPORT, FL, 338375905, US

Contacts
Phone +1 813-685-2191
Fax 8136898755
Phone +1 863-421-7626
Fax 8634210886

Authorized person
Name DR. PERUMALSWAMY RAJARAM
Role PRESIDENT
Phone 8136852191

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
License Number ME0040960
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2015 593602551 2016-08-05 RAJARAM, P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH SUITE 203, DAVENPORT, FL, 338375905
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2014 593602551 2015-06-19 RAJARAM, P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2013 593602551 2014-09-29 RAJARAM, P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2012 593602551 2013-10-07 RAJARAM, P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905

Signature of
Role Plan administrator
Date 2013-10-07
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-07
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2011 593602551 2012-10-15 RAJARAM, P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905

Plan administrator’s name and address
Administrator’s EIN 593602551
Plan administrator’s name RAJARAM, P.A.
Plan administrator’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905
Administrator’s telephone number 8634217626

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2010 593602551 2011-10-17 RAJARAM, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905

Plan administrator’s name and address
Administrator’s EIN 593602551
Plan administrator’s name RAJARAM, P.A.
Plan administrator’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905
Administrator’s telephone number 8634217626

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-17
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2010 593602551 2011-10-17 RAJARAM, P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905

Plan administrator’s name and address
Administrator’s EIN 593602551
Plan administrator’s name RAJARAM, P.A.
Plan administrator’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905
Administrator’s telephone number 8634217626

Signature of
Role Plan administrator
Date 2011-10-17
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-17
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2009 593602551 2010-09-28 RAJARAM, P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 U.S. HIGHWAY 27 NORTH, SUITE, DAVENPORT, FL, 33837

Plan administrator’s name and address
Administrator’s EIN 593602551
Plan administrator’s name RAJARAM, P.A.
Plan administrator’s address 40124 U.S. HIGHWAY 27 NORTH, SUITE, DAVENPORT, FL, 33837
Administrator’s telephone number 8634217626

Signature of
Role Plan administrator
Date 2010-09-27
Name of individual signing PERUMALSWAMY RAJARAM
Valid signature Filed with authorized/valid electronic signature
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2009 593602551 2011-10-21 RAJARAM, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905

Plan administrator’s name and address
Administrator’s EIN 593602551
Plan administrator’s name RAJARAM, P.A.
Plan administrator’s address 40124 US HIGHWAY 27 NORTH #203, DAVENPORT, FL, 338375905
Administrator’s telephone number 8634217626

Signature of
Role Plan administrator
Date 2011-10-21
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-21
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
RAJARAM, P.A. DEFINED BENEFIT PENSION PLAN 2009 593602551 2010-09-27 RAJARAM, P.A. 3
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 8634217626
Plan sponsor’s address 40124 U.S. HIGHWAY 27 NORTH, SUITE, DAVENPORT, FL, 33837

Plan administrator’s name and address
Administrator’s EIN 593602551
Plan administrator’s name RAJARAM, P.A.
Plan administrator’s address 40124 U.S. HIGHWAY 27 NORTH, SUITE, DAVENPORT, FL, 33837
Administrator’s telephone number 8634217626

Signature of
Role Plan administrator
Date 2010-09-26
Name of individual signing PERUMALSWAMY RAJARAM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RAJARAM P Agent 40124 US HWY 27, DAVENPORT, FL, 33837

Director

Name Role Address
RAJARAM PERUMALSWAMY Director 5024, LATROBE DR, WINDERMERE, FL, 34786

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 No data No data
REGISTERED AGENT ADDRESS CHANGED 2003-01-28 40124 US HWY 27, SUITE 203, DAVENPORT, FL 33837 No data
CHANGE OF PRINCIPAL ADDRESS 2002-02-20 40124 US HWY 27, SUITE 203, DAVENPORT, FL 33837 No data
CHANGE OF MAILING ADDRESS 2002-02-20 40124 US HWY 27, SUITE 203, DAVENPORT, FL 33837 No data
REGISTERED AGENT NAME CHANGED 2001-04-19 RAJARAM, P No data

Documents

Name Date
ANNUAL REPORT 2015-02-25
ANNUAL REPORT 2014-01-28
ANNUAL REPORT 2013-01-19
ANNUAL REPORT 2012-02-22
ANNUAL REPORT 2011-03-16
ANNUAL REPORT 2010-04-01
ANNUAL REPORT 2009-04-04
ANNUAL REPORT 2008-04-12
ANNUAL REPORT 2007-01-14
ANNUAL REPORT 2006-01-17

Related by officers

RAJARAM PERUMALSWAMY

HIGHLAND, L.L.C.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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