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  5. JACKSONVILLE KIDS PEDIATRICS, PLLC

JACKSONVILLE KIDS PEDIATRICS, PLLC

Company Details

Entity Name: JACKSONVILLE KIDS PEDIATRICS, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 16 May 2008 (17 years ago)
Document Number: L08000049116
FEI/EIN Number 262656419
Address: 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 32256
Mail Address: 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 32256
ZIP code: 32256
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1083871404 2008-05-22 2008-05-22 13743 SAXON LAKE DR, JACKSONVILLE, FL, 322252624, US 7807 BAYMEADOWS RD E, SUITE 207, JACKSONVILLE, FL, 322569664, US

Contacts
Phone +1 904-253-3459

Authorized person
Name ALEXANDRA MARY KOSTUR
Role OWNER
Phone 9042533459

Taxonomy
Taxonomy Code 261QP2300X - Primary Care Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2023 262656419 2024-06-06 JACKSONVILLE KIDS PEDIATRICS, PLLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2024-06-06
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-06
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2022 262656419 2023-10-16 JACKSONVILLE KIDS PEDIATRICS, PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-16
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2021 262656419 2022-06-29 JACKSONVILLE KIDS PEDIATRICS, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2022-06-29
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-29
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2020 262656419 2021-08-25 JACKSONVILLE KIDS PEDIATRICS, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2021-08-25
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2019 262656419 2020-07-08 JACKSONVILLE KIDS PEDIATRICS, PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-08
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2018 262656419 2019-07-10 JACKSONVILLE KIDS PEDIATRICS, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2019-07-10
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-10
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
JACKSONVILLE KIDS PEDIATRICS 401(K) PLAN 2017 262656419 2018-07-11 JACKSONVILLE KIDS PEDIATRICS, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-07-01
Business code 621112
Sponsor’s telephone number 9044469991
Plan sponsor’s address 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL, 322569666

Signature of
Role Plan administrator
Date 2018-07-11
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-11
Name of individual signing ALEXANDRA KOSTUR
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FRAZIER W. ROBINSON Agent 1515 RIVERSIDE AVE., SUITE A, JACKSONVILLE, FL, 32204

Manager

Name Role Address
KOSTUR ALEXANDRA MMD Manager 7807 BAYMEADOWS ROAD EAST, JACKSONVILLE, FL, 32256

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2009-04-10 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL 32256 No data
CHANGE OF MAILING ADDRESS 2009-04-10 7807 BAYMEADOWS ROAD EAST, SUITE 207, JACKSONVILLE, FL 32256 No data

Documents

Name Date
ANNUAL REPORT 2025-01-16
ANNUAL REPORT 2024-02-28
ANNUAL REPORT 2023-01-11
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-01-30
ANNUAL REPORT 2020-04-03
ANNUAL REPORT 2019-02-28
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-01-11
ANNUAL REPORT 2016-03-16

Related by officers

KOSTUR ALEXANDRA MMD

7807 BAYMEADOWS ROAD EAST #207, LLC HAPPY MINDS HEALTHY BODIES, LLC

FRAZIER W. ROBINSON

INTERSTATEWEST PARK, LLC 14TH STREET FERNANDINA, LLC 4705 CAPITAL, LLC PENMAN SQUARE, LLC FOREST EDGE ESTATE, LLC 7807 BAYMEADOWS ROAD EAST #207, LLC CF INDUSTRIAL PROPERTIES, LLC PHOENIX MEDICAL GROUP, PLLC 2618 HERSCHEL STREET, LLC 10066 103RD STREET, 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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