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  5. MEDIC INFUSION PA

MEDIC INFUSION PA

Company Details

Entity Name: MEDIC INFUSION PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 04 Jan 2005 (20 years ago)
Date of dissolution: 27 Sep 2024 (4 months ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (4 months ago)
Document Number: P05000001221
FEI/EIN Number 202094100
Address: 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 33952, US
Mail Address: 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 33952, US
ZIP code: 33952
County: Charlotte
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1215275649 2013-01-18 2013-09-19 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 339526755, US 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 339526755, US

Contacts
Phone +1 941-613-1919
Fax 9416134077

Authorized person
Name MICHAEL R METYK
Role OWNER/PODIATRIST
Phone 9416131919

Taxonomy
Taxonomy Code 213ES0103X - Foot & Ankle Surgery Podiatrist
License Number PO2884
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDIC INFUSION PA 401(K) PLAN & TRUST 2021 202094100 2023-02-13 MEDIC INFUSION PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD., UNIT D, PORT CHARLOTTE, FL, 339526755
MEDIC INFUSION PA 401(K) PLAN & TRUST 2020 202094100 2021-10-05 MEDIC INFUSION PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD., UNIT D, PORT CHARLOTTE, FL, 339526755
MEDIC INFUSION PA 401(K) PLAN & TRUST 2019 202094100 2020-08-04 MEDIC INFUSION PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD., UNIT D, PORT CHARLOTTE, FL, 339526755
MEDIC INFUSION PA 401(K) PLAN & TRUST 2018 202094100 2019-10-07 MEDIC INFUSION PA 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD., UNIT D, PORT CHARLOTTE, FL, 339526755

Signature of
Role Plan administrator
Date 2019-10-07
Name of individual signing MICHAEL R. METYK
Valid signature Filed with authorized/valid electronic signature
MEDIC INFUSION PA 401(K) PLAN & TRUST 2017 202094100 2018-11-05 MEDIC INFUSION PA 2
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 33952
MEDIC INFUSION PA 401(K) PLAN & TRUST 2017 202094100 2018-11-06 MEDIC INFUSION PA 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 33952
MEDIC INFUSION PA 401(K) PLAN & TRUST 2017 202094100 2018-11-05 MEDIC INFUSION PA 2
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL, 33952
MEDIC INFUSION PA 401(K) PLAN & TRUST 2017 202094100 2018-10-15 MEDIC INFUSION PA 2
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 9416131919
Plan sponsor’s address 3191 HARBOR BLVD., UNIT D, PORT CHARLOTTE, FL, 339526755

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing MICHAEL R. METYK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
METYK MICHAEL Agent 3191 HARBOR BLVD, Port Charlotte, FL, 33952

President

Name Role Address
METYK MICHAEL President 13332 Golf Pointe Dr, PORT CHARLOTTE, FL, 33953

Secretary

Name Role Address
METYK Tetyana Secretary 13332 Golf Pointe Dr, PORT CHARLOTTE, FL, 33953

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 No data No data
REGISTERED AGENT ADDRESS CHANGED 2021-01-27 3191 HARBOR BLVD, SUITE D, Port Charlotte, FL 33952 No data
REGISTERED AGENT NAME CHANGED 2020-11-09 METYK, MICHAEL No data
CHANGE OF PRINCIPAL ADDRESS 2020-10-28 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL 33952 No data
REINSTATEMENT 2018-08-03 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 No data No data
REINSTATEMENT 2015-11-11 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
NAME CHANGE AMENDMENT 2013-09-16 MEDIC INFUSION PA No data
CHANGE OF MAILING ADDRESS 2012-02-01 3191 HARBOR BLVD, UNIT D, PORT CHARLOTTE, FL 33952 No data

Documents

Name Date
ANNUAL REPORT 2023-01-19
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-27
AMENDED ANNUAL REPORT 2020-11-09
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-01-04
REINSTATEMENT 2018-08-03
ANNUAL REPORT 2016-04-15
REINSTATEMENT 2015-11-11
ANNUAL REPORT 2014-03-03

Related by officers

METYK MICHAEL

METYK MEDICAL ASSOCIATES PA METFORD REAL ESTATE LLC SPRINKLES SOLUTIONS, LLC CHARLEY SOLUTIONS, LLC SNIFFY SOLUTIONS, 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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