| Entity Name: | OB & GYN SPECIALISTS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
OB & GYN SPECIALISTS, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 01 Jan 1980 (45 years ago) |
| Date of dissolution: | 28 Sep 2012 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (13 years ago) |
| Document Number: | 649549 |
| FEI/EIN Number |
591960318
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| Address: | 1551 CLAY STREET, WINTER PARK, FL, 32789, US |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1184760506 | 2007-01-30 | 2008-01-09 | 1551 CLAY ST, WINTER PARK, FL, 327895499, US | 1551 CLAY ST, WINTER PARK, FL, 327895499, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-644-5371 |
| Fax | 4076441417 |
Authorized person
| Name | MATTHEW R MERVIS |
| Role | ADMINISTRATOR |
| Phone | 4076445371 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0030235 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0030722 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0043553 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0049918 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0063738 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0064647 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0062994 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0067143 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0071558 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0083622 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0086331 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME99195 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME100440 |
| State | FL |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF OB & GYN SPECIALISTS, P.A. | 2011 | 591960318 | 2012-05-30 | OB & GYN SPECIALISTS, P.A. | 72 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 591960318 |
| Plan administrator’s name | OB & GYN SPECIALISTS, P.A. |
| Plan administrator’s address | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| Administrator’s telephone number | 4075995900 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-30 |
| Name of individual signing | MARK A. WILSTRUP, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1980-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4075995900 |
| Plan sponsor’s address | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
Plan administrator’s name and address
| Administrator’s EIN | 591960318 |
| Plan administrator’s name | OB & GYN SPECIALISTS, P.A. |
| Plan administrator’s address | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| Administrator’s telephone number | 4075995900 |
Signature of
| Role | Plan administrator |
| Date | 2011-06-09 |
| Name of individual signing | MATTHEW R. MERVIS, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1980-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4075995900 |
| Plan sponsor’s address | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
Plan administrator’s name and address
| Administrator’s EIN | 591960318 |
| Plan administrator’s name | OB & GYN SPECIALISTS, P.A. |
| Plan administrator’s address | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| Administrator’s telephone number | 4075995900 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-11 |
| Name of individual signing | MATTHEW R. MERVIS, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DIEBEL N DONALD M | President | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| DIEBEL N DONALD M | Director | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| WILSTRUP MARK A | Secretary | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| WILSTRUP MARK A | Director | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| LAZAR ARNOLD J | Treasurer | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| LAZAR ARNOLD J | Director | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| DURKEE DENNISE C | Assistant Secretary | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| DURKEE DENNISE C | Director | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| MERVIS MATTHEW R | Assistant Treasurer | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| MERVIS MATTHEW R | Director | 1551 CLAY STREET, WINTER PARK, FL, 32789 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-09 | 1551 CLAY STREET, WINTER PARK, FL 32789 | - |
| CANCEL ADM DISS/REV | 2009-12-18 | - | - |
| REGISTERED AGENT NAME CHANGED | 2009-12-18 | DIEBEL, N. DONALD M.D. | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | - | - |
| NAME CHANGE AMENDMENT | 1987-10-05 | OB & GYN SPECIALISTS, P.A. | - |
| NAME CHANGE AMENDMENT | 1986-07-11 | OB & GYN SPECIALISTS, DIEBEL, LAZAR, STROUP, EPLEY AND WILSTRUP, M.D., P.A. | - |
| NAME CHANGE AMENDMENT | 1983-06-15 | OB & GYN SPECIALISTS, DIEBEL, LAZAR AND STROUP, M.D., P.A. | - |
| CHANGE OF MAILING ADDRESS | 1982-04-07 | 1551 CLAY STREET, WINTER PARK, FL 32789 | - |
| REGISTERED AGENT ADDRESS CHANGED | 1982-04-07 | 1551 CLAY STREET, WINTER PARK, FL 32789 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-03-18 |
| ANNUAL REPORT | 2010-04-09 |
| REINSTATEMENT | 2009-12-18 |
| ANNUAL REPORT | 2008-05-02 |
| ANNUAL REPORT | 2007-04-30 |
| ANNUAL REPORT | 2006-05-09 |
| ANNUAL REPORT | 2005-05-02 |
| ANNUAL REPORT | 2004-07-15 |
| ANNUAL REPORT | 2003-02-10 |
| ANNUAL REPORT | 2002-03-12 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
