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

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

Company Details

Entity Name: MIGUEL J. TEPEDINO, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 14 Jul 2009 (16 years ago)
Document Number: P09000060069
FEI/EIN Number 27-0548001
Address: 1722 SW NEWLAND WAY, LAKE CITY, FL 32025
Mail Address: Post Office Box 2603, LAKE CITY, FL 32056-2603
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2020 270548001 2021-10-15 MIGUEL J. TEPEDINO, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2019 270548001 2020-10-22 MIGUEL J. TEPEDINO, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address P.O. BOX 2603, LAKE CITY, FL, 32056
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2018 270548001 2019-10-15 MIGUEL J. TEPEDINO, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address P.O. BOX 2603, LAKE CITY, FL, 32056
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2017 270548001 2018-10-11 MIGUEL J. TEPEDINO, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2016 270548001 2017-10-08 MIGUEL J. TEPEDINO, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Signature of
Role Plan administrator
Date 2017-10-08
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2015 270548001 2016-05-26 MIGUEL J. TEPEDINO, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Signature of
Role Plan administrator
Date 2016-05-25
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2014 270548001 2015-07-05 MIGUEL J. TEPEDINO, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Signature of
Role Plan administrator
Date 2015-07-05
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2013 270548001 2014-09-26 MIGUEL J. TEPEDINO, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Signature of
Role Plan administrator
Date 2014-09-26
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
MIGUEL J. TEPEDINO, M.D., P.A. 401(K) PLAN 2012 270548001 2013-10-10 MIGUEL J. TEPEDINO, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
MIGUEL J. TEPEDINO, M.D., P.A. 401K PLAN 2011 270548001 2012-07-13 MIGUEL J. TEPEDINO, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 3867594111
Plan sponsor’s address PO BOX 2603, LAKE CITY, FL, 32056

Plan administrator’s name and address
Administrator’s EIN 270548001
Plan administrator’s name MIGUEL J. TEPEDINO, M.D., P.A.
Plan administrator’s address PO BOX 2603, LAKE CITY, FL, 32056
Administrator’s telephone number 3867594111

Signature of
Role Plan administrator
Date 2012-07-13
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-13
Name of individual signing MIGUEL J. TEPEDINO, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CORTES, JOSE H, Jr. Agent 4 SOUTHEAST BROADWAY STREET, OCALA, FL 34471

President

Name Role Address
TEPEDINO, MIGUEL JM.D. President POST OFFICE BOX 2603, LAKE CITY, FL 32056-2603

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 No data 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 No data
CHANGE OF MAILING ADDRESS 2017-04-28 1722 SW NEWLAND WAY, LAKE CITY, FL 32025 No data
REGISTERED AGENT NAME CHANGED 2017-04-28 CORTES, JOSE H, Jr. No data

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

Related by officers

CORTES, JOSE H, Jr.

CENTRAL FLORIDA P.A.C.S., INC ASSURANCE HOME PHONE SERVICES, INC. G-5 REAL ESTATE HOLDINGS, LLC ABSOLUTE MOBILE, INC. TSB RETAIL, LLC CODIA DEVELOPMENT, LLC MARION INVESTMENT GROUP, LLC JAWC INVESTMENTS GROUP, LLC MERRICOR GROUP, LLC

Related by address

1722 SW NEWLAND WAY, LAKE CITY, FL 32025

NORTH FLORIDA DERMATOLOGY, LLC TEPEDINO REAL ESTATE HOLDINGS, LLC EAB RE HOLDINGS, LLC

Date of last update: 25 Jan 2025

Sources: Florida Department of State

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