PULMONARY DISEASE ASSOCIATES, P.A. EMPLOYEES' PS PLAN
|
2012
|
591801116
|
2014-06-17
|
PULMONARY DISEASE ASSOCIATES, P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1978-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
2392748500
|
Plan sponsor’s
address |
5216 CLAYTON CT., FORT MYERS, FL, 33901
|
Signature of
Role |
Plan administrator |
Date |
2014-06-17 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2014-06-17 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PULMONARY DISEASE ASSOCIATES, P.A. EMPLOYEES' PS PLAN
|
2011
|
591801116
|
2013-08-14
|
PULMONARY DISEASE ASSOCIATES, P.A.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1978-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
2392748500
|
Plan sponsor’s
address |
5216 CLAYTON CT., FORT MYERS, FL, 33907
|
Plan administrator’s name and address
Administrator’s EIN |
591801116 |
Plan administrator’s name |
PULMONARY DISEASE ASSOCIATES, P.A. |
Plan administrator’s
address |
5216 CLAYTON CT., FORT MYERS, FL, 33907 |
Administrator’s telephone number |
2392748500 |
Signature of
Role |
Plan administrator |
Date |
2013-08-14 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2013-08-14 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PULMONARY DISEASE ASSOCIATES, P.A. EMPLOYEES' PS PLAN
|
2010
|
591801116
|
2012-08-14
|
PULMONARY DISEASE ASSOCIATES, P.A.
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1978-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
2392748500
|
Plan sponsor’s
address |
3620 BROADWAY AVE., FORT MYERS, FL, 33901
|
Plan administrator’s name and address
Administrator’s EIN |
591801116 |
Plan administrator’s name |
PULMONARY DISEASE ASSOCIATES, P.A. |
Plan administrator’s
address |
3620 BROADWAY AVE., FORT MYERS, FL, 33901 |
Administrator’s telephone number |
2392748500 |
Signature of
Role |
Plan administrator |
Date |
2012-08-14 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2012-08-14 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
PULMONARY DISEASE ASSOCIATES, P.A. EMPLOYEES' PS PLAN
|
2009
|
591801116
|
2011-08-16
|
PULMONARY DISEASE ASSOCIATES, P.A.
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1978-04-01
|
Business code |
621111
|
Sponsor’s telephone number |
2392748500
|
Plan sponsor’s
address |
3620 BROADWAY AVE., FORT MYERS, FL, 33901
|
Plan administrator’s name and address
Administrator’s EIN |
591801116 |
Plan administrator’s name |
PULMONARY DISEASE ASSOCIATES, P.A. |
Plan administrator’s
address |
3620 BROADWAY AVE., FORT MYERS, FL, 33901 |
Administrator’s telephone number |
2392748500 |
Signature of
Role |
Plan administrator |
Date |
2011-08-16 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2011-08-16 |
Name of individual signing |
RAZAK DOSANI, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|