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  5. TRI COUNTY PODIATRY, P.A.

TRI COUNTY PODIATRY, P.A.

Company Details

Entity Name: TRI COUNTY PODIATRY, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 31 Oct 2005 (19 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 28 Oct 2016 (8 years ago)
Document Number: P05000146408
FEI/EIN Number 20-3729549
Address: 340 Heald Way, Bldg 100, Bldg 100, The Villages, FL 32163
Mail Address: 340 Heald Way, Bldg 100, Bldg 100, The Villages, FL 32163
ZIP code: 32163
County: Sumter
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1396287884 2016-11-15 2016-11-15 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 321596820, US 340 HEALD WAY, BLDG 100, THE VILLAGES, FL, 321636087, US

Contacts
Phone +1 352-259-1919
Fax 3522592042

Authorized person
Name FELIX J ESAREY
Role OWNER
Phone 3522591919

Taxonomy
Taxonomy Code 213ES0103X - Foot & Ankle Surgery Podiatrist
Is Primary No
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2023 203729549 2024-07-18 TRI COUNTY PODIATRY, P.A. 29
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 340 HEALD WAY BLDG 100, THE VILLAGES, FL, 32163

Signature of
Role Plan administrator
Date 2024-07-18
Name of individual signing SHIRLEY HORNER
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2023 203729549 2024-10-02 TRI COUNTY PODIATRY, P.A. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 340 HEALD WAY BLDG 100, THE VILLAGES, FL, 32163

Signature of
Role Plan administrator
Date 2024-10-02
Name of individual signing VANESSA URREGO
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2022 203729549 2023-06-23 TRI COUNTY PODIATRY, P.A. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2023-06-23
Name of individual signing NICK RICE
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2021 203729549 2022-05-25 TRI COUNTY PODIATRY, P.A. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing JENINE FRAZIER
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2020 203729549 2021-06-03 TRI COUNTY PODIATRY, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2021-06-03
Name of individual signing JENINE FRAZIER
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2019 203729549 2020-06-16 TRI COUNTY PODIATRY, P.A. 32
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2020-06-16
Name of individual signing JFRAZIER1585
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2019 203729549 2020-06-30 TRI COUNTY PODIATRY, P.A. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2020-06-30
Name of individual signing JENINE FRAZIER
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2018 203729549 2019-06-10 TRI COUNTY PODIATRY, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2019-06-10
Name of individual signing JENINE FRAZIER
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2017 203729549 2018-06-13 TRI COUNTY PODIATRY, P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2018-06-13
Name of individual signing JENINE FRAZIER
Valid signature Filed with authorized/valid electronic signature
TRI COUNTY PODIATRY P.A. 401(K) PLAN 2016 203729549 2017-07-12 TRI COUNTY PODIATRY, P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621391
Sponsor’s telephone number 3522591919
Plan sponsor’s address 1585 SANTA BARBARA BLVD, STE B, THE VILLAGES, FL, 32159

Signature of
Role Plan administrator
Date 2017-07-12
Name of individual signing JENINE FRAZIER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Wu, Johnny L Agent 340 Heald Way, Bldg 100, Bldg 100, The Villages, FL 32163

President

Name Role Address
Wu, Johnny L President 340 Heald Way, Bldg 100, Bldg 100 The Villages, FL 32163

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000018807 TRI COUNTY FOOT & ANKLE ACTIVE 2016-02-23 2027-12-31 No data 1585 SANTA BARBARA BLVD, SUITE B, LADY LAKE, FL, 32159

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-01-26 340 Heald Way, Bldg 100, Bldg 100, The Villages, FL 32163 No data
CHANGE OF MAILING ADDRESS 2024-01-26 340 Heald Way, Bldg 100, Bldg 100, The Villages, FL 32163 No data
REGISTERED AGENT ADDRESS CHANGED 2024-01-26 340 Heald Way, Bldg 100, Bldg 100, The Villages, FL 32163 No data
REINSTATEMENT 2016-10-28 No data No data
REGISTERED AGENT NAME CHANGED 2016-10-28 Wu, Johnny L No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-02
ANNUAL REPORT 2024-01-26
ANNUAL REPORT 2023-01-09
ANNUAL REPORT 2022-01-11
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-01-13
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-01-06
REINSTATEMENT 2016-10-28

Related by officers

Wu, Johnny L

TRI COUNTY PODIATRY TWO, LLC

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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