| Entity Name: | MILLA PEDIATRICS AND ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Oct 1998 (26 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P98000089106 |
| FEI/EIN Number | 593537428 |
| Address: | 426 SW Commerce Dr, Suite 101, LAKE CITY, FL, 32025, US |
| Mail Address: | 426 SW Commerce Dr, Suite 101, LAKE CITY, FL, 32025, US |
| ZIP code: | 32025 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356500987 | 2008-06-09 | 2008-06-09 | 6400 W NEWBERRY RD, SUITE 207, GAINESVILLE, FL, 326056605, US | 1847 SW BARNETT WAY, LAKE CITY, FL, 320256957, US | |||||||||||||||||||||||||||||
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| Phone | +1 352-332-6644 |
| Fax | 3523328251 |
| Phone | +1 386-755-2240 |
| Fax | 3867556598 |
Authorized person
| Name | DR. PAULINO MILLA |
| Role | PRESIDENT |
| Phone | 3523326644 |
Taxonomy
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| License Number | ME0058262 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 375159701 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MILLA PEDIATRICS AND 401 (K) PROFIT SHARING PLAN | 2009 | 593537428 | 2012-05-02 | MILLA PEDIATRICS AND ASSOCIATES, INC | 7 | |||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 593537428 |
| Plan administrator’s name | PAM CARLISLE |
| Plan administrator’s address | 1847 SW BARNETT WAY, LAKE CITY, FL, 32025 |
| Administrator’s telephone number | 3867552240 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 0 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-02 |
| Name of individual signing | PAM CARLISLE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| MILLA PAULINO | Agent | 426 SW Commerce Dr, LAKE CITY, FL, 32025 |
| Name | Role | Address |
|---|---|---|
| MILLA PAULINO | Director | 1756 NorhtGlen Circle, Middleburg, FL, 32068 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-17 | 426 SW Commerce Dr, Suite 101, LAKE CITY, FL 32025 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-17 | 426 SW Commerce Dr, Suite 101, LAKE CITY, FL 32025 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-01-17 | 426 SW Commerce Dr, Suite 101, LAKE CITY, FL 32025 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-01-17 |
| ANNUAL REPORT | 2013-03-08 |
| ANNUAL REPORT | 2012-02-07 |
| ANNUAL REPORT | 2011-04-14 |
| ANNUAL REPORT | 2010-02-18 |
| ANNUAL REPORT | 2009-06-25 |
| ANNUAL REPORT | 2008-05-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
