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  5. MDY PRIMARY CARE MEDICINE, P.A.

MDY PRIMARY CARE MEDICINE, P.A.

Company Details

Entity Name: MDY PRIMARY CARE MEDICINE, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 07 Nov 2000 (24 years ago)
Date of dissolution: 30 Mar 2012 (13 years ago)
Last Event: CONVERSION
Event Date Filed: 30 Mar 2012 (13 years ago)
Document Number: P00000104314
FEI/EIN Number 593681028
Address: 40124 HIGHWAY 27, SUITE 104, DAVENPORT, FL, 33837
Mail Address: 40124 HIGHWAY 27, SUITE 104, 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
1497974133 2007-04-24 2017-01-03 102 PARK PLACE BLVD, DAVENPORT, FL, 338376857, US 102 PARK PLACE BLVD, DAVENPORT, FL, 338376857, US

Contacts
Phone +1 863-422-0032
Fax 8634223275

Authorized person
Name MARGARET R YEE
Role OWNER
Phone 8634220032

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME0072925
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICARE RAILROAD CARRIER
Number DG2237
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MDY PRIMARY CARE MEDICINE, P.A. 401(K) PROFIT SHARING PLAN 2015 593681028 2016-04-06 MDY PRIMARY CARE MEDICINE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8634220032
Plan sponsor’s address 102 PARK PLACE BLVD., DAVENPORT, FL, 33837

Signature of
Role Plan administrator
Date 2016-04-04
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-04
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
MDY PRIMARY CARE MEDICINE, P.A. 401(K) PROFIT SHARING PLAN 2011 593681028 2012-04-25 MDY PRIMARY CARE MEDICINE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8634220032
Plan sponsor’s address 40124 HWY 27 NORTH, SUITE 104, DAVENPORT, FL, 33837

Plan administrator’s name and address
Administrator’s EIN 593681028
Plan administrator’s name MDY PRIMARY CARE MEDICINE, P.A.
Plan administrator’s address 40124 HWY 27 NORTH, SUITE 104, DAVENPORT, FL, 33837
Administrator’s telephone number 8634220032

Signature of
Role Plan administrator
Date 2012-04-24
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-04-24
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
MDY PRIMARY CARE MEDICINE, P.A. 401(K) PROFIT SHARING PLAN 2010 593681028 2011-03-31 MDY PRIMARY CARE MEDICINE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8634220032
Plan sponsor’s address 40124 HWY 27 NORTH, SUITE 104, DAVENPORT, FL, 33837

Plan administrator’s name and address
Administrator’s EIN 593681028
Plan administrator’s name MDY PRIMARY CARE MEDICINE, P.A.
Plan administrator’s address 40124 HWY 27 NORTH, SUITE 104, DAVENPORT, FL, 33837
Administrator’s telephone number 8634220032

Signature of
Role Plan administrator
Date 2011-03-30
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-30
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
MDY PRIMARY CARE MEDICINE, P.A. 401K PROFIT SHARING PLAN 2009 593681028 2010-07-16 MDY PRIMARY CARE MEDICINE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 8634220032
Plan sponsor’s address 40124 HWY 27 NORTH, SUITE 104, DAVENPORT, FL, 33837

Plan administrator’s name and address
Administrator’s EIN 593681028
Plan administrator’s name MDY PRIMARY CARE MEDICINE, P.A.
Plan administrator’s address 40124 HWY 27 NORTH, SUITE 104, DAVENPORT, FL, 33837
Administrator’s telephone number 8634220032

Signature of
Role Plan administrator
Date 2010-07-15
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-15
Name of individual signing MARGARET YEE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRYANT CARLA DELOACH Agent 1206 EAST RIDGEWOOD STREET, ORLANDO, FL, 32803

Director

Name Role Address
YEE MARGARET R Director 40124 HIGHWAY 27, SUITE 104, DAVENPORT, FL, 33837

President

Name Role Address
YEE MARGARET R President 40124 HIGHWAY 27, SUITE 104, DAVENPORT, FL, 33837

Events

Event Type Filed Date Value Description
CONVERSION 2012-03-30 No data CONVERSION MEMBER. RESULTING CORPORATION WAS L12000045159. CONVERSION NUMBER 500000121495
CHANGE OF PRINCIPAL ADDRESS 2011-04-13 40124 HIGHWAY 27, SUITE 104, DAVENPORT, FL 33837 No data
CHANGE OF MAILING ADDRESS 2011-04-13 40124 HIGHWAY 27, SUITE 104, DAVENPORT, FL 33837 No data
REGISTERED AGENT NAME CHANGED 2011-04-13 BRYANT, CARLA DELOACH No data
REGISTERED AGENT ADDRESS CHANGED 2004-11-01 1206 EAST RIDGEWOOD STREET, ORLANDO, FL 32803 No data

Documents

Name Date
ANNUAL REPORT 2012-03-26
ANNUAL REPORT 2011-04-13
ANNUAL REPORT 2010-03-02
ANNUAL REPORT 2009-02-25
ANNUAL REPORT 2008-04-04
ANNUAL REPORT 2007-03-12
ANNUAL REPORT 2006-02-13
ANNUAL REPORT 2005-03-21
Reg. Agent Change 2004-11-01
ANNUAL REPORT 2004-03-11

Related by officers

YEE MARGARET R

SERVING MEDICAL, LLC MDY PRIMARY CARE MEDICINE, P.L. LEGACY 8, LLC MMCS PROPERTY, LLC

BRYANT CARLA DELOACH

RESONANTSONIC INTERNATIONAL, INC. SLIPPERY CREEK III, LLLP PREPARE4LIFE, LLC FERNCREEK - LAKEVIEW, LLC DOUBLE MM HOME SALES, LLC EEB HOLDINGS, LLC RETAIL MANAGEMENT, LLC ED BLANTON, DDS, P.A. PROVERBS 3:9 FOUNDATION, INC. DON GEORGE, 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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