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  5. LARRY T. WONG, D.O., P.A.

LARRY T. WONG, D.O., P.A.

Company Details

Entity Name: LARRY T. WONG, D.O., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 14 Mar 2005 (20 years ago)
Document Number: P05000038269
FEI/EIN Number 202477100
Address: 502 N MACARTHUR AVE, STE C, PANAMA CITY, FL, 32401
Mail Address: PO BOX 16266, PANAMA CITY, FL, 32406
ZIP code: 32401
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1376715409 2008-03-28 2012-10-15 502 N MACARTHUR AVE, SUITE C, PANAMA CITY, FL, 324013654, US 502 N MACARTHUR AVE, SUITE C, PANAMA CITY, FL, 324013654, US

Contacts
Phone +1 850-215-1080
Fax 8502151086

Authorized person
Name DR. LARRY T WONG
Role PHYSICIAN
Phone 8502151080

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
License Number OS9154
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICARE PROVIDER NUMBER
Number 48027Y
Issuer MEDICAID
Number 270357200
State FL
Issuer BLUE CROSS/BLUE SHIELD
Number 48027

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LARRY T. WONG, D.O. P.A. CASH BALANCE PLAN 2023 202477100 2024-09-12 LARRY T. WONG, D.O. P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2024-09-11
Name of individual signing LARRY WONG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-11
Name of individual signing LARRY WONG
Valid signature Filed with authorized/valid electronic signature
LARRY T. WONG, D.O., P.A. 401K PROFIT SHARING PLAN 2022 202477100 2024-02-15 LARRY T. WONG, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O. P.A. CASH BALANCE PLAN 2022 202477100 2023-09-26 LARRY T. WONG, D.O. P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2023-09-22
Name of individual signing LARRY WONG
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-22
Name of individual signing LARRY WONG
Valid signature Filed with authorized/valid electronic signature
LARRY T. WONG, D.O., P.A. CASH BALANCE PENSION PLAN 2021 202477100 2022-10-17 LARRY T. WONG, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O., P.A. 401K PROFIT SHARING PLAN 2021 202477100 2022-10-17 LARRY T. WONG, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O., P.A. CASH BALANCE PENSION PLAN 2020 202477100 2021-10-08 LARRY T. WONG, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O., P.A. 401K PROFIT SHARING PLAN 2020 202477100 2021-10-08 LARRY T. WONG, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O., P.A. 401K PROFIT SHARING PLAN 2019 202477100 2020-10-06 LARRY T. WONG, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O., P.A. CASH BALANCE PENSION PLAN 2019 202477100 2020-10-05 LARRY T. WONG, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401
LARRY T. WONG, D.O., P.A. 401K PROFIT SHARING PLAN 2018 202477100 2019-10-08 LARRY T. WONG, D.O., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 8502151080
Plan sponsor’s address 502 N. MACARTHUR AVENUE, PANAMA CITY, FL, 32401

Agent

Name Role Address
WONG LARRY T Agent 2900 TUPELO DRIVE, PANAMA CITY, FL, 32405

Director

Name Role Address
WONG LARRY T Director 2900 TUPELO DRIVE, PANAMA CITY, FL, 32405

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2009-04-14 502 N MACARTHUR AVE, STE C, PANAMA CITY, FL 32401 No data

Documents

Name Date
ANNUAL REPORT 2024-04-21
ANNUAL REPORT 2023-03-13
ANNUAL REPORT 2022-04-10
ANNUAL REPORT 2021-04-17
ANNUAL REPORT 2020-03-21
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-04-19
ANNUAL REPORT 2017-04-17
ANNUAL REPORT 2016-03-03
ANNUAL REPORT 2015-03-03

Related by officers

WONG LARRY T

THERAPY PROPERTIES, LLC

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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