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  5. TERENCE PEPPARD, M.D., P.A.

TERENCE PEPPARD, M.D., P.A.

Company Details

Entity Name: TERENCE PEPPARD, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 09 Nov 1994 (30 years ago)
Document Number: P94000082395
FEI/EIN Number 65-0531485
Address: TERENCE PEPPARD MDPA, 3663 SOUTH MIAMI AVE., MIAMI, FL 33133
Mail Address: TERENCE PEPPARD MDPA, 4350 N. JEFFERSON AVE., MIAMI BEACH, FL 33140
ZIP code: 33133
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992783385 2006-01-05 2023-10-12 4350 N JEFFERSON AVE, MIAMI BEACH, FL, 331402934, US 3663 S MIAMI AVE, KOHLY CENTER AT MERCY, MIAMI, FL, 331334253, US

Contacts
Phone +1 305-652-7134
Fax 3056773126

Authorized person
Name EILEEN FEINERMAN
Role OFFICE MANAGER
Phone 3056527134

Taxonomy
Taxonomy Code 208100000X - Physical Medicine & Rehabilitation Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 376722100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2023 650531485 2024-07-08 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2024-07-08
Name of individual signing EILEEN FEINERMAN
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2022 650531485 2023-10-04 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2023-10-04
Name of individual signing EILEEN FEINERMAN
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2021 650531485 2022-06-14 TERENCE PEPPARD, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2022-06-14
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2020 650531485 2021-06-09 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2021-06-09
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2019 650531485 2020-06-08 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2020-06-08
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2018 650531485 2019-08-12 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2019-08-12
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2017 650531485 2018-09-16 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2018-09-16
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2016 650531485 2017-10-15 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2017-10-15
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2015 650531485 2016-10-05 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2016-10-05
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature
TERENCE PEPPARD, M.D., P.A. PROFIT SHARING PLAN 2014 650531485 2015-09-25 TERENCE PEPPARD, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3056517239
Plan sponsor’s address 4350 NORTH JEFFERSON AVENUE, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2015-09-25
Name of individual signing TERENCE PEPPARD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FEINERMAN, ELLEEN Agent 4350 NORTH JEFFERSON AVE., PENTHOUSE, MIAMI BEACH, FL 33140

President

Name Role Address
TERENCE PEPPARD MD President 3663 SOUTH MIAMI AVE., MIAMI, FL 33133

Secretary

Name Role Address
TERENCE PEPPARD MD Secretary 3663 SOUTH MIAMI AVE., MIAMI, FL 33133

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2000-03-28 TERENCE PEPPARD MDPA, 3663 SOUTH MIAMI AVE., MIAMI, FL 33133 No data
CHANGE OF MAILING ADDRESS 1997-04-10 TERENCE PEPPARD MDPA, 3663 SOUTH MIAMI AVE., MIAMI, FL 33133 No data
REGISTERED AGENT NAME CHANGED 1997-04-10 FEINERMAN, ELLEEN No data
REGISTERED AGENT ADDRESS CHANGED 1997-04-10 4350 NORTH JEFFERSON AVE., PENTHOUSE, MIAMI BEACH, FL 33140 No data

Documents

Name Date
ANNUAL REPORT 2024-02-08
ANNUAL REPORT 2023-03-10
ANNUAL REPORT 2022-02-21
ANNUAL REPORT 2021-02-17
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-10
ANNUAL REPORT 2018-03-03
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-01-19

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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