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  5. MY PEDIATRICIAN, P.A.

MY PEDIATRICIAN, P.A.

Company Details

Entity Name: MY PEDIATRICIAN, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 22 May 2006 (19 years ago)
Document Number: P06000072731
FEI/EIN Number 205019586
Address: 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511
Mail Address: 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511, US
ZIP code: 33511
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1619128675 2008-10-08 2008-10-08 1037 PROFESSIONAL PARK DR, BRANDON, FL, 335114886, US 1037 PROFESSIONAL PARK DR, BRANDON, FL, 335114886, US

Contacts
Phone +1 813-684-5659

Authorized person
Name ALICIA MEDRANO ONG
Role PEDIATRICIAN/OWNER
Phone 8136845659

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
License Number ME78831
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MY PEDIATRICIAN P A 401(K) PROFIT SHARING PLAN & TRUST 2023 205019586 2024-07-24 MY PEDIATRICIAN P A 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2024-07-24
Name of individual signing DONALD STEVEN BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401(K) PROFIT SHARING PLAN & TRUST 2022 205019586 2023-07-06 MY PEDIATRICIAN P A 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2023-07-06
Name of individual signing DONALD BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401(K) PROFIT SHARING PLAN & TRUST 2021 205019586 2022-07-21 MY PEDIATRICIAN P A 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2022-07-21
Name of individual signing STEVE BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401(K) PROFIT SHARING PLAN & TRUST 2020 205019586 2021-07-16 MY PEDIATRICIAN P A 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2021-07-16
Name of individual signing DONALD BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401(K) PROFIT SHARING PLAN & TRUST 2019 205019586 2020-07-17 MY PEDIATRICIAN P A 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2020-07-17
Name of individual signing DONALD STEVEN BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401 K PROFIT SHARING PLAN TRUST 2018 205019586 2019-07-14 MY PEDIATRICIAN P A 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2019-07-14
Name of individual signing DONALD STEVEN BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401 K PROFIT SHARING PLAN TRUST 2017 205019586 2018-07-26 MY PEDIATRICIAN P A 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing DONALD S BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401 K PROFIT SHARING PLAN TRUST 2016 205019586 2017-07-17 MY PEDIATRICIAN P A 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2017-07-17
Name of individual signing DONALD STEVEN BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401 K PROFIT SHARING PLAN TRUST 2015 205019586 2016-07-25 MY PEDIATRICIAN P A 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2016-07-25
Name of individual signing DONALD S BURWELL
Valid signature Filed with authorized/valid electronic signature
MY PEDIATRICIAN P A 401 K PROFIT SHARING PLAN TRUST 2014 205019586 2015-07-22 MY PEDIATRICIAN P A 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8134161266
Plan sponsor’s address 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

Signature of
Role Plan administrator
Date 2015-07-22
Name of individual signing DONALD STEVEN BURWELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ONG ALICIA MMD Agent 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL, 33511

President

Name Role Address
ONG ALICIA MMD President 1037 Professional Park Drive, Brandon, FL, 33511

Secretary

Name Role Address
ONG ALICIA MMD Secretary 1037 Professional Park Drive, Brandon, FL, 33511

Director

Name Role Address
ONG ALICIA MMD Director 1037 Professional Park Drive, Brandon, FL, 33511

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2014-04-21 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL 33511 No data
REGISTERED AGENT NAME CHANGED 2014-04-21 ONG, ALICIA M, MD No data
REGISTERED AGENT ADDRESS CHANGED 2014-04-21 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL 33511 No data
CHANGE OF PRINCIPAL ADDRESS 2009-04-20 1037 PROFESSIONAL PARK DRIVE, BRANDON, FL 33511 No data

Documents

Name Date
ANNUAL REPORT 2024-04-02
ANNUAL REPORT 2023-03-02
ANNUAL REPORT 2022-02-11
ANNUAL REPORT 2021-03-08
ANNUAL REPORT 2020-06-04
ANNUAL REPORT 2019-04-23
ANNUAL REPORT 2018-04-16
ANNUAL REPORT 2017-05-29
ANNUAL REPORT 2016-04-24
ANNUAL REPORT 2015-04-26

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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