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MIGUEL J. TEPEDINO, M.D., P.A.

MIGUEL J. TEPEDINO, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name:	MIGUEL J. TEPEDINO, M.D., P.A.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Active
Date Filed:	14 Jul 2009 (16 years ago)
Document Number:	P09000060069
FEI/EIN Number	270548001
Address:	1722 SW NEWLAND WAY, LAKE CITY, FL, 32025, US
Mail Address:	Post Office Box 2603, LAKE CITY, FL, 32056-2603, US
ZIP code:	32025
City:	Lake City
County:	Columbia
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
TEPEDINO MIGUEL J	President	POST OFFICE BOX 2603, LAKE CITY, FL, 320562603
CORTES JOSE HJr.	Agent	4 SOUTHEAST BROADWAY STREET, OCALA, FL, 34471

National Provider Identifier

NPI Number:

1275763427

Certification Date:

2021-05-03

Link:

View on NPI website

Authorized Person:

Name:

MIGUEL J TEPEDINO

Role:

OWNER

Phone:

3867544111

Taxonomy:

Selected Taxonomy:

207Q00000X - Family Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 386-754-4117

Phone:

+1 386-754-4111

Fax:

3867544118

Form 5500 Series

Employer Identification Number (EIN):

270548001

Plan Year:

2020

Number Of Participants:

11

Sponsors Telephone Number:

3867594111

File:

Plan Year:

2019

Number Of Participants:

10

Sponsors Telephone Number:

3867594111

File:

Plan Year:

2018

Number Of Participants:

6

Sponsors Telephone Number:

3867594111

File:

Plan Year:

2017

Number Of Participants:

8

Sponsors Telephone Number:

3867594111

File:

Plan Year:

2016

Number Of Participants:

7

Sponsors Telephone Number:

3867594111

File:

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G09000154621	NORTH FLORIDA FAMILY MEDICINE	EXPIRED	2009-09-11	2014-12-31	-	1717 SOUTHWEST NEWLAND WAY, LAKE CITY, FL, 32056-2603

Events

Event Type	Filed Date	Value	Description
CHANGE OF PRINCIPAL ADDRESS	2022-04-27	1722 SW NEWLAND WAY, LAKE CITY, FL 32025	-
CHANGE OF MAILING ADDRESS	2017-04-28	1722 SW NEWLAND WAY, LAKE CITY, FL 32025	-
REGISTERED AGENT NAME CHANGED	2017-04-28	CORTES, JOSE H, Jr.	-

Documents

Name	Date
ANNUAL REPORT	2024-01-16
ANNUAL REPORT	2023-03-17
ANNUAL REPORT	2022-04-27
ANNUAL REPORT	2021-05-02
ANNUAL REPORT	2020-01-20
ANNUAL REPORT	2019-03-11
ANNUAL REPORT	2018-03-29
ANNUAL REPORT	2017-04-28
ANNUAL REPORT	2016-01-20
ANNUAL REPORT	2015-04-22

Paycheck Protection Program

Jobs Reported:

10

Initial Approval Amount:

$90,229

Date Approved:

2020-04-09

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$90,229

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Non-Veteran

Forgiveness Amount:

$91,028.53

Servicing Lender:

Millennium Bank

Use of Proceeds:

Payroll: $90,229

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Date of last update: 03 Aug 2025

Sources: Florida Department of State