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  5. EDWIN LIU, M.D., P.A.

EDWIN LIU, M.D., P.A.

Company Details

Entity Name: EDWIN LIU, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 09 Oct 2000 (24 years ago)
Document Number: P00000094891
FEI/EIN Number 651045187
Address: 12959 PALMS WEST DRIVE, SUITE 120, LOXAHATCHEE, FL, 33470, US
Mail Address: 12959 PALMS WEST DRIVE, SUITE 120, LOXAHATCHEE, FL, 33470, US
ZIP code: 33470
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2023 651045187 2024-07-16 EDWIN LIU, M.D. P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS W DRIVE #120, LOXAHATCHEE, FL, 33470

Signature of
Role Plan administrator
Date 2024-07-16
Name of individual signing ROSA LIU
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-16
Name of individual signing ROSA LIU
Valid signature Filed with incorrect/unrecognized electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2022 651045187 2023-08-15 EDWIN LIU, M.D. P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2023-08-15
Name of individual signing ROSA LIU
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2021 651045187 2022-07-01 EDWIN LIU, M.D. P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2022-07-01
Name of individual signing ROSA LIU
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2020 651045187 2021-08-23 EDWIN LIU, M.D. P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2021-08-23
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2019 651045187 2020-04-20 EDWIN LIU, M.D. P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2020-04-20
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2018 651045187 2019-05-24 EDWIN LIU, M.D. P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2019-05-24
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2017 651045187 2018-05-07 EDWIN LIU, M.D. P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2018-05-07
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2016 651045187 2017-06-07 EDWIN LIU, M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2017-06-07
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2015 651045187 2016-07-12 EDWIN LIU, M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature
EDWIN LIU MD PA 401(K) PROFIT SHARING PLAN 2014 651045187 2015-07-02 EDWIN LIU, M.D. P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 5617538888
Plan sponsor’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470

Plan administrator’s name and address
Administrator’s EIN 651045187
Plan administrator’s name EDWIN LIU, M.D. P.A.
Plan administrator’s address 12959 PALMS WEST DRIVE #120, LOXAHATCHEE, FL, 33470
Administrator’s telephone number 5617538888

Signature of
Role Plan administrator
Date 2015-07-02
Name of individual signing MICHELLE PIETANZA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
LIU EDWIN M Agent 12959 PALMS WEST DRIVE, LOXAHATCHEE, FL, 33470

Manager

Name Role Address
LIU EDWIN M Manager 12959 Palms West Dr Ste 120, Loxahatchee, FL, 33470
LIU ROSA L Manager 12959 PALMS WEST DRIVE, LOXAHATCHEE, FL, 33470

Director

Name Role Address
LIU EDWIN M Director 12959 Palms West Dr Ste 120, Loxahatchee, FL, 33470

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000034745 PEDIATRIC SLEEP CENTERS OF FLORIDA ACTIVE 2016-04-05 2026-12-31 No data 12959 PALMS WEST DRIVE, ST 120, LOXAHATCHEE, FL, 33470
G07142900275 PEDIATRIC NEUROLOGISTS OF PALM BEACH ACTIVE 2007-05-22 2027-12-31 No data 12959 PALMS WEST DRIVE, SUITE 120, LOXAHATCHEE, FL, 33470-9291

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2009-04-07 12959 PALMS WEST DRIVE, SUITE 120, LOXAHATCHEE, FL 33470 No data
CHANGE OF PRINCIPAL ADDRESS 2008-01-07 12959 PALMS WEST DRIVE, SUITE 120, LOXAHATCHEE, FL 33470 No data
REGISTERED AGENT ADDRESS CHANGED 2008-01-07 12959 PALMS WEST DRIVE, SUITE 120, LOXAHATCHEE, FL 33470 No data
REGISTERED AGENT NAME CHANGED 2004-03-03 LIU, EDWIN MD No data

Documents

Name Date
ANNUAL REPORT 2025-01-25
ANNUAL REPORT 2024-02-09
ANNUAL REPORT 2023-01-24
ANNUAL REPORT 2022-02-11
ANNUAL REPORT 2021-02-25
ANNUAL REPORT 2020-03-20
ANNUAL REPORT 2019-02-01
ANNUAL REPORT 2018-01-19
ANNUAL REPORT 2017-01-20
AMENDED ANNUAL REPORT 2016-05-19

Related by officers

LIU ROSA L

REVEL PROPERTIES, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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