2020 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED

DOCUMENT# P02000033590 Apr 27, 2020

Entity Name: PEDIATRIC PARTNERS OF PONTE VEDRA, P.A. Secretary of State
3472987050CC
Current Principal Place of Business:
5270 PALM VALLEY RD
PONTE VEDRA BEACH, FL 32082

Current Mailing Address:

5270 PALM VALLEY RD
PONTE VEDRA BEACH, FL 32082

FEI Number: 04-3627325 Certificate of Status Desired: No

Name and Address of Current Registered Agent:
BUCKLEY, JULIE A
5270 PALM VALLEY ROAD
PONTE VEDRA BEACH, FL 32082 US

The above named entity submits this statement for the purpose of changing its registered office or registered agent, or both, in the State of Florida.

SIGNATURE: JULIE A BUCKLEY 04/27/2020

Electronic Signature of Registered Agent Date

Officer/Director Detail :
Title DR. Title OFFICER
Name BUCKLEY, JULIE A Name MOORE, MATTHEW CHRISTOPHER
Address 5270 PALM VALLEY ROAD Address 728 LAKE STONE CIRCLE
City-State-Zip: PONTE VEDRA BEACH FL 32082 City-State-Zip: PONTE VEDRA BEACH FL 32082

I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under
oath; that I am an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607, Florida Statutes; and that my name appears
above, or on an attachment with all other like empowered.

SIGNATURE: JULIE A BUCKLEY OWNER 04/27/2020

Electronic Signature of Signing Officer/Director Detail Date