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  5. PEDIATRIC SURGERY, P.A.

PEDIATRIC SURGERY, P.A. - Florida Company Profile

Company Details

Entity Name: PEDIATRIC SURGERY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

PEDIATRIC SURGERY, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 29 Apr 1992 (33 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 07 Jul 1992 (33 years ago)
Document Number: V32811
FEI/EIN Number 593119905

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 98 Spring Lane, Winter Park, FL, 32789, US
Mail Address: 98 Spring Lane, Winter Park, FL, 32789, US
ZIP code: 32789
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1023039351 2006-07-21 2015-11-18 1220 SLIGH BLVD, ORLANDO, FL, 328061108, US 1220 SLIGH BLVD, ORLANDO, FL, 328061108, US

Contacts
Phone +1 407-228-4774
Fax 4072282128

Authorized person
Name MARK S CHAET
Role PRESIDENT
Phone 4072284774

Taxonomy
Taxonomy Code 2086S0120X - Pediatric Surgery Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 253269700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2021 593119905 2022-06-15 PEDIATRIC SURGERY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2022-06-15
Name of individual signing ANTHONY WARREN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2021 593119905 2022-10-14 PEDIATRIC SURGERY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing ANTHONY WARREN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2020 593119905 2021-09-28 PEDIATRIC SURGERY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2021-09-28
Name of individual signing ADAM WARREN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2019 593119905 2020-10-14 PEDIATRIC SURGERY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing ADAM WARREN
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2018 593119905 2019-08-14 PEDIATRIC SURGERY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2019-08-14
Name of individual signing MARK CHAET
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2017 593119905 2018-07-02 PEDIATRIC SURGERY, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2018-07-02
Name of individual signing MARK CHAET
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2016 593119905 2017-07-03 PEDIATRIC SURGERY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD., ORLANDO, FL, 32806

Signature of
Role Plan administrator
Date 2017-07-03
Name of individual signing MARK CHAET
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2015 593119905 2016-08-31 PEDIATRIC SURGERY, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD, ORLANDO, FL, 328061108

Signature of
Role Plan administrator
Date 2016-08-31
Name of individual signing MARK CHAET
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2014 593119905 2015-07-29 PEDIATRIC SURGERY, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD, ORLANDO, FL, 328061108

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing MARK CHAET
Valid signature Filed with authorized/valid electronic signature
PEDIATRIC SURGERY, P.A. 401(K) PROFIT SHARING PLAN 2013 593119905 2014-07-21 PEDIATRIC SURGERY, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-05-01
Business code 622000
Sponsor’s telephone number 4072284774
Plan sponsor’s address 1220 SLIGH BLVD, ORLANDO, FL, 328061108

Signature of
Role Plan administrator
Date 2014-07-21
Name of individual signing MARK CHAET
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
Chaet Mark S President 98 Spring Lane, Winter Park, FL, 32789
CHAET MARK S Agent 98 Spring Lane, Winter Park, FL, 32789

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-02-23 98 Spring Lane, Winter Park, FL 32789 -
REGISTERED AGENT ADDRESS CHANGED 2023-02-23 98 Spring Lane, Winter Park, FL 32789 -
CHANGE OF MAILING ADDRESS 2022-02-06 98 Spring Lane, Winter Park, FL 32789 -
REGISTERED AGENT NAME CHANGED 2017-01-30 CHAET, MARK S -
NAME CHANGE AMENDMENT 1992-07-07 PEDIATRIC SURGERY, P.A. -

Documents

Name Date
ANNUAL REPORT 2024-03-07
ANNUAL REPORT 2023-02-23
ANNUAL REPORT 2022-02-06
ANNUAL REPORT 2021-02-02
ANNUAL REPORT 2020-02-14
ANNUAL REPORT 2019-03-26
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-30
ANNUAL REPORT 2016-03-01
ANNUAL REPORT 2015-01-11

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CHAET MARK S

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LN GOLDENROD, LLC - Inactive
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ZASAAM PROPERTIES I, LLC - Active
Florida Limited Liability Co. (2009 )
ZASAAM PROPERTIES I, LLC - Active
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LN BELLA MARE, LLC - Inactive
Foreign Limited Liability Co. (2005 - 2010)
FLORIDA CHILDREN'S PHYSICIANS AND SURGEONS, INC. - Inactive
Domestic Non-Profit (1997 - 2020)
ZASAAM PROPERTIES II, LLC - Active
Florida Limited Liability Co. (2009 )
ZASAAM PROPERTIES II, LLC - Active
Florida Limited Liability Co. (2009 )
SKD UNITED, LLC - Active
Florida Limited Liability Co. (2016 )

Companies related by address

98 Spring Lane, Winter Park, FL, 32789, US

ALLIANCE PROPERTIES DELAND, LLC SKD UNITED, LLC SKD UNITED NORTH, LLC KIDSDOCS FLORIDA. LLC SKS UNITED, LLC

98 Spring Lane, Winter Park, FL, 32789, US

ALLIANCE PROPERTIES DELAND, LLC SKD UNITED, LLC SKD UNITED NORTH, LLC KIDSDOCS FLORIDA. LLC SKS UNITED, LLC

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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