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  5. CECILIO HERNANDEZ MD PA

CECILIO HERNANDEZ MD PA

Company Details

Entity Name: CECILIO HERNANDEZ MD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 29 Jun 2007 (18 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 20 Nov 2019 (5 years ago)
Document Number: P07000076067
FEI/EIN Number 262432451
Address: 4102 N, MACDILL AVE, SUITE A, TAMPA, FL, 33607
Mail Address: 4102 N, MACDILL AVE, SUITE A, TAMPA, FL, 33607
ZIP code: 33607
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1811156045 2008-06-03 2008-06-09 4102 N MACDILL AVE, TAMPA, FL, 336076717, US 4102 N MACDILL AVE, TAMPA, FL, 336076717, US

Contacts
Phone +1 813-657-0027
Fax 8138771609

Authorized person
Name DR. CECILIO HERNANDEZ
Role PRESIDENT
Phone 8136570027

Taxonomy
Taxonomy Code 207RN0300X - Nephrology Physician
License Number ME0068187
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 378115100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2023 262432451 2024-12-05 CECILIO HERNANDEZ MD PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2022 262432451 2024-02-13 CECILIO HERNANDEZ MD PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2021 262432451 2023-02-14 CECILIO HERNANDEZ MD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2020 262432451 2023-02-07 CECILIO HERNANDEZ MD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2019 262432451 2020-10-13 CECILIO HERNANDEZ MD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2018 262432451 2020-10-13 CECILIO HERNANDEZ MD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2018 262432451 2019-10-14 CECILIO HERNANDEZ MD PA 4
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2017 262432451 2018-10-11 CECILIO HERNANDEZ MD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2016 262432451 2017-07-26 CECILIO HERNANDEZ MD PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607
CECILIO HERNANDEZ MD PA PROFIT SHARING PLAN AND TRUST 2015 262432451 2016-09-26 CECILIO HERNANDEZ MD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 8138703979
Plan sponsor’s address 4102 N MACDILL AVE, SUITE A, TAMPA, FL, 33607

Agent

Name Role Address
HERNANDEZ CECILIO Agent 4102 N, MACDILL AVE, TAMPA, FL, 33607

President

Name Role Address
HERNANDEZ CECILIO President 4102 N, MACDILL AVE STE A, TAMPA, FL, 33607

Events

Event Type Filed Date Value Description
REINSTATEMENT 2019-11-20 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 No data No data
REINSTATEMENT 2015-10-21 No data No data
REGISTERED AGENT NAME CHANGED 2015-10-21 HERNANDEZ, CECILIO No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
REGISTERED AGENT ADDRESS CHANGED 2011-01-11 4102 N, MACDILL AVE, SUITE A, TAMPA, FL 33607 No data
CHANGE OF PRINCIPAL ADDRESS 2011-01-11 4102 N, MACDILL AVE, SUITE A, TAMPA, FL 33607 No data
CHANGE OF MAILING ADDRESS 2011-01-11 4102 N, MACDILL AVE, SUITE A, TAMPA, FL 33607 No data
AMENDMENT AND NAME CHANGE 2008-05-16 CECILIO HERNANDEZ MD PA No data

Documents

Name Date
ANNUAL REPORT 2024-04-09
ANNUAL REPORT 2023-04-19
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-04-07
ANNUAL REPORT 2020-06-22
REINSTATEMENT 2019-11-20
ANNUAL REPORT 2017-04-07
ANNUAL REPORT 2016-03-29
REINSTATEMENT 2015-10-21
ANNUAL REPORT 2014-02-13

Related by officers

HERNANDEZ CECILIO

A DRYWALL-FINISH OF MIAMI, INC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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