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  5. MOUM & NIELSEN, P.A.

MOUM & NIELSEN, P.A.

Company Details

Entity Name: MOUM & NIELSEN, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 16 Sep 1969 (55 years ago)
Date of dissolution: 15 Sep 2016 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 15 Sep 2016 (8 years ago)
Document Number: 601402
FEI/EIN Number 59-1276754
Address: 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL 33432
Mail Address: 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL 33432
ZIP code: 33432
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOUM & NIELSEN, P. A. 401(K) PROFIT SHARING PLAN 2014 591276754 2015-04-14 MOUM & NIELSEN, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-10-01
Business code 621111
Sponsor’s telephone number 5613958701
Plan sponsor’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432

Signature of
Role Plan administrator
Date 2015-04-14
Name of individual signing ERIC E MOUM, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-14
Name of individual signing ERIC E MOUM, MD
Valid signature Filed with authorized/valid electronic signature
MOUM & NIELSEN, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2013 591276754 2014-07-07 MOUM & NIELSEN, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-10-01
Business code 621111
Sponsor’s telephone number 5613958701
Plan sponsor’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432

Signature of
Role Plan administrator
Date 2014-07-07
Name of individual signing ERIC E MOUM, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-07
Name of individual signing ERIC E MOUM, MD
Valid signature Filed with authorized/valid electronic signature
MOUM & NIELSEN, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2012 591276754 2013-06-26 MOUM & NIELSEN, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-10-01
Business code 621111
Sponsor’s telephone number 5613958701
Plan sponsor’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432

Signature of
Role Plan administrator
Date 2013-06-26
Name of individual signing ERIC EE MOUM, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-26
Name of individual signing ERIC EE MOUM, MD
Valid signature Filed with authorized/valid electronic signature
MOUM & NIELSEN, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2011 591276754 2012-08-30 MOUM & NIELSEN, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-10-01
Business code 621111
Sponsor’s telephone number 5613958701
Plan sponsor’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432

Plan administrator’s name and address
Administrator’s EIN 591276754
Plan administrator’s name MOUM & NIELSEN, P.A.
Plan administrator’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432
Administrator’s telephone number 5613958701

Signature of
Role Plan administrator
Date 2012-08-30
Name of individual signing ERIC MOUM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-08-30
Name of individual signing ERIC MOUM
Valid signature Filed with authorized/valid electronic signature
MOUM & NIELSEN, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2010 650416923 2011-10-12 MOUM & NIELSEN, P.A. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-10-01
Business code 621111
Sponsor’s telephone number 5613958701
Plan sponsor’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432

Plan administrator’s name and address
Administrator’s EIN 650416923
Plan administrator’s name MOUM & NIELSEN, P.A.
Plan administrator’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432
Administrator’s telephone number 5613958701

Signature of
Role Plan administrator
Date 2011-10-12
Name of individual signing ERIC MOUM
Valid signature Filed with authorized/valid electronic signature
MOUM & NIELSEN, P.A. PROFIT SHARING PLAN AND TRUST 2009 650416923 2010-06-24 MOUM & NIELSEN, P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-10-01
Business code 621111
Sponsor’s telephone number 5613958701
Plan sponsor’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432

Plan administrator’s name and address
Administrator’s EIN 650416923
Plan administrator’s name MOUM & NIELSEN, P.A.
Plan administrator’s address 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL, 33432
Administrator’s telephone number 5613958701

Signature of
Role Plan administrator
Date 2010-06-24
Name of individual signing ERIC MOUM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MOUM, ERIC Agent 445 S FEDERAL HWY, BOCA RATON, FL 33432

President

Name Role Address
MOUM, ERIC President 445 S. FEDERAL HIGHWAY, BOCA RATON, FL 33432

Treasurer

Name Role Address
MOUM, ERIC Treasurer 445 S. FEDERAL HIGHWAY, BOCA RATON, FL 33432

Vice President

Name Role Address
NIELSEN, TIMOTHY A Vice President 445 S. FEDERAL HWY, BOCA RATON, FL 33432

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2016-09-15 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2014-09-26 No data No data
NAME CHANGE AMENDMENT 2005-02-08 MOUM & NIELSEN, P.A. No data
REGISTERED AGENT NAME CHANGED 2004-02-04 MOUM, ERIC No data
CHANGE OF PRINCIPAL ADDRESS 2004-02-04 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL 33432 No data
NAME CHANGE AMENDMENT 2000-09-18 FOLSOM, MOUM & NIELSEN, P.A. No data
CHANGE OF MAILING ADDRESS 2000-03-24 445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL 33432 No data
NAME CHANGE AMENDMENT 1993-12-21 NIELSEN, BARRETT, FOLSOM & MOUM, P.A. No data
NAME CHANGE AMENDMENT 1991-07-05 NIELSEN, BARRETT & FOLSOM, P.A. No data
NAME CHANGE AMENDMENT 1986-04-08 HEARD, NIELSEN, BARRETT & FOLSOM, P.A. No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2016-09-15
ANNUAL REPORT 2013-04-23
ANNUAL REPORT 2012-01-10
ANNUAL REPORT 2011-03-16
ANNUAL REPORT 2010-03-18
ANNUAL REPORT 2009-03-24
ANNUAL REPORT 2008-04-02
ANNUAL REPORT 2007-04-10
ANNUAL REPORT 2006-04-03
Name Change 2005-02-08

Related by officers

NIELSEN, TIMOTHY A

SEACREST DENTAL-MEDICAL CONDOMINIUM ASSOCIATION, INC.

Related by address

445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL 33432

BOCA RATON DERMATOPATHOLOGY LABORATORY, INC.

445 SOUTH FEDERAL HIGHWAY, BOCA RATON, FL 33432

BOCA RATON DERMATOPATHOLOGY LABORATORY, INC.

Date of last update: 06 Feb 2025

Sources: Florida Department of State

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