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  5. EDWARD D. TRIBUZIO, M.D., P.A.

EDWARD D. TRIBUZIO, M.D., P.A. - Florida Company Profile

Company Details

Entity Name: EDWARD D. TRIBUZIO, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

EDWARD D. TRIBUZIO, M.D., 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: 25 Jul 1986 (39 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 25 Apr 2022 (3 years ago)
Document Number: J26107
FEI/EIN Number 592694637

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 1340 S 18TH STREET, #204, FERNANDINA BEACH, FL, 32034, US
Mail Address: 91 Oyster Catcher Boat, FERNANDINA BEACH, FL, 32034, US
ZIP code: 32034
County: Nassau
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1891063509 2011-12-08 2011-12-08 1340 S 18TH ST, SUITE 204, FERNANDINA BEACH, FL, 320344799, US 1340 S 18TH ST, SUITE 204, FERNANDINA BEACH, FL, 320344799, US

Contacts
Phone +1 904-261-0643

Authorized person
Name DR. EDWARD DOMINICK TRIBUZIO
Role OWNER/PHYSICIAN
Phone 9042610643

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
License Number FLME42515
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 067854600
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2023 592694637 2024-07-20 EDWARD D. TRIBUZIO, M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 91 OYSTER CATCHER ROAD, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2024-07-20
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2022 592694637 2023-10-01 EDWARD D. TRIBUZIO, M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 91 OYSTER CATCHER ROAD, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2023-10-01
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2021 592694637 2023-03-26 EDWARD D. TRIBUZIO, M.D., P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2023-03-26
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2020 592694637 2022-01-30 EDWARD D. TRIBUZIO, M.D., P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2022-01-30
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2019 592694637 2021-03-08 EDWARD D. TRIBUZIO, M.D., P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2021-03-08
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2018 592694637 2020-03-31 EDWARD D. TRIBUZIO, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2020-03-31
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2017 592694637 2018-12-31 EDWARD D. TRIBUZIO, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2018-12-31
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2016 592694637 2017-12-28 EDWARD D. TRIBUZIO, M.D., P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2017-12-28
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2015 592694637 2017-03-29 EDWARD D. TRIBUZIO, M.D., P.A. 10
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2017-03-29
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature
EDWARD D. TRIBUZIO, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2015 592694637 2017-04-06 EDWARD D. TRIBUZIO, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-07-22
Business code 621111
Sponsor’s telephone number 9042610643
Plan sponsor’s address 1340 SOUTH 18TH STREET, SUITE 204, FERNANDINA BEACH, FL, 32034

Signature of
Role Plan administrator
Date 2017-04-06
Name of individual signing EDWARD D. TRIBUZIO
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
TRIBUZIO, EDWARD D. M.D. TSDP 1340 S 18TH STREET, STE 204, FERNANDINA BEACH, FL, 32034
FT CORPORATE SERVICES, LLC Agent -

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-05-15 1340 S 18TH STREET, #204, FERNANDINA BEACH, FL 32034 -
REGISTERED AGENT NAME CHANGED 2023-05-15 FT Corporate Services, LLC -
REGISTERED AGENT ADDRESS CHANGED 2023-05-15 501 Riverside Avenue, Suite 700, Jacksonville, FL 32202 -
REINSTATEMENT 2022-04-25 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2021-09-24 - -
CHANGE OF PRINCIPAL ADDRESS 1999-04-22 1340 S 18TH STREET, #204, FERNANDINA BEACH, FL 32034 -

Documents

Name Date
ANNUAL REPORT 2024-03-14
ANNUAL REPORT 2023-05-15
REINSTATEMENT 2022-04-25
ANNUAL REPORT 2020-03-11
ANNUAL REPORT 2019-04-16
ANNUAL REPORT 2018-03-26
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-02-05
ANNUAL REPORT 2015-04-21
ANNUAL REPORT 2014-03-20

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Companies related by address

No other companies in our directory share the same address as EDWARD D. TRIBUZIO, M.D., P.A.

Date of last update: 02 Apr 2025

Sources: Florida Department of State

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