| Entity Name: | JAMES R. HOMAN, D.O., INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 04 Dec 1975 (49 years ago) |
| Document Number: | 492021 |
| FEI/EIN Number | 591636542 |
| Address: | 4212 S. MANHATTAN AVE., TAMPA, FL, 33611 |
| Mail Address: | 2900 W VILLA ROSA PARK, TAMPA, FL, 33611, US |
| ZIP code: | 33611 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871896506 | 2010-12-20 | 2010-12-20 | 4212 S MANHATTAN AVE, TAMPA, FL, 336111302, US | 4212 S MANHATTAN AVE, TAMPA, FL, 336111302, US | |||||||||||||||||||
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| Phone | +1 813-837-8591 |
| Fax | 8138396832 |
Authorized person
| Name | DR. JAMES R. HOMAN |
| Role | PHYSICIAN |
| Phone | 8138738591 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | OS3261 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES R. HOMAN, D. O., INC., PROFIT SHARING PLAN | 2013 | 591636542 | 2014-12-04 | JAMES R. HOMAN, D.O., INC. | 5 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2014-12-04 |
| Name of individual signing | JAMES HOMAN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1976-03-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8138378591 |
| Plan sponsor’s address | 4212 S. MANHATTAN AVENUE, TAMPA, FL, 33611 |
Signature of
| Role | Plan administrator |
| Date | 2013-12-20 |
| Name of individual signing | JAMES HOMAN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1976-03-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8138378591 |
| Plan sponsor’s address | 4212 S. MANHATTAN AVENUE, TAMPA, FL, 33611 |
Plan administrator’s name and address
| Administrator’s EIN | 591636542 |
| Plan administrator’s name | JAMES R. HOMAN, D.O., INC. |
| Plan administrator’s address | 4212 S. MANHATTAN AVENUE, TAMPA, FL, 33611 |
| Administrator’s telephone number | 8138378591 |
Signature of
| Role | Plan administrator |
| Date | 2013-06-20 |
| Name of individual signing | JAMES HOMAN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HOMAN JAMES RDr. | Agent | 2900 W VILLA ROSA PARK, TAMPA, FL, 33611 |
| Name | Role | Address |
|---|---|---|
| HOMAN JAMES RDr. | President | 4212 S MANHATTAN, TAMPA, FL, 33611 |
| Name | Role | Address |
|---|---|---|
| HOMAN BRIAN D | Vice President | 4212 S MANHATTAN, TAMPA, FL, 33611 |
| Name | Role | Address |
|---|---|---|
| HOMAN JAMES RDr. | Director | 4212 S MANHATTAN, TAMPA, FL, 33611 |
| Name | Role | Address |
|---|---|---|
| HOMAN JUDITH A | Secretary | 4212 S MANHATTAN, TAMPA, FL, 33611 |
| Name | Role | Address |
|---|---|---|
| HOMAN JUDITH A | Treasurer | 4212 S MANHATTAN, TAMPA, FL, 33611 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000025013 | HOMAN HEALTH AND WELLNESS | EXPIRED | 2012-03-12 | 2017-12-31 | No data | 4212 S. MANHATTAN AVE., TAMPA, FL, 33611 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-02-02 | No data | No data |
| AMENDMENT AND NAME CHANGE | 1999-09-21 | JAMES R. HOMAN, D.O., INC. | No data |
| AMENDED AND RESTATEDARTICLES | 1984-07-02 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
