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  5. PALM BEACH ATLANTIC UNIVERSITY, INC.

PALM BEACH ATLANTIC UNIVERSITY, INC.

Headquarter

Company Details

Entity Name: PALM BEACH ATLANTIC UNIVERSITY, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Not For Profit Corporation
Status: Active
Date Filed: 13 Jun 1968 (57 years ago)
Last Event: RESTATED ARTICLES
Event Date Filed: 30 Jun 2022 (3 years ago)
Document Number: 714765
FEI/EIN Number 59-1092732
Address: 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401
Mail Address: P O BOX 24708, WEST PALM BEACH, FL 33416-4708
ZIP code: 33401
County: Palm Beach
Place of Formation: FLORIDA

Links between entities

Type Company Name Company Number State
Headquarter of PALM BEACH ATLANTIC UNIVERSITY, INC., MISSISSIPPI 1186907 MISSISSIPPI
Headquarter of PALM BEACH ATLANTIC UNIVERSITY, INC., KENTUCKY 1102284 KENTUCKY
Headquarter of PALM BEACH ATLANTIC UNIVERSITY, INC., KENTUCKY 1405429 KENTUCKY
Headquarter of PALM BEACH ATLANTIC UNIVERSITY, INC., COLORADO 20191744495 COLORADO
Headquarter of PALM BEACH ATLANTIC UNIVERSITY, INC., CONNECTICUT 2990824 CONNECTICUT
Headquarter of PALM BEACH ATLANTIC UNIVERSITY, INC., ILLINOIS CORP_73052661 ILLINOIS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689044687 2015-10-02 2024-10-10 901 S FLAGER DR, WEST PALM BEACH, FL, 334016505, US 901 S FLAGER DR, WEST PALM BEACH, FL, 334016505, US

Contacts
Phone +1 561-803-2338
Fax 5618032532

Authorized person
Name MRS. MICHELLE MENARD III
Role ATHLETIC TRAINING ADMINISTRATOR
Phone 5618032338

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary No
Taxonomy Code 207XX0005X - Sports Medicine (Orthopaedic Surgery) Physician
Is Primary No
Taxonomy Code 2255A2300X - Athletic Trainer
Is Primary Yes

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
254900NPYY2UU89TGI52 714765 US-FL GENERAL ACTIVE No data

Addresses
Legal c/o Howard, Marcia, 901 S. Flagler Dr., West Palm Beach, US-FL, US, 33401
Headquarters 901 S. Flagler Dr., west palm beach, US-FL, US, 33401

Registration details
Registration Date 2021-09-15
Last Update 2022-09-16
Status LAPSED
Next Renewal 2022-09-15
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As 714765

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2023 591092732 2024-09-24 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 357

Signature of
Role Plan administrator
Date 2024-09-23
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-23
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2022 591092732 2023-08-16 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 404

Signature of
Role Plan administrator
Date 2023-08-16
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2021 591092732 2022-08-26 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 387

Signature of
Role Plan administrator
Date 2022-08-26
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-08-26
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2020 591092732 2021-08-31 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 393

Signature of
Role Plan administrator
Date 2021-08-31
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-08-31
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2019 591092732 2020-09-22 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 418

Signature of
Role Plan administrator
Date 2020-09-22
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-22
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2018 591092732 2019-08-13 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 406

Signature of
Role Plan administrator
Date 2019-08-13
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-13
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2018 591092732 2019-08-13 PALM BEACH ATLANTIC UNIVERSITY 0
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 406

Signature of
Role Plan administrator
Date 2019-08-13
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-13
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2017 591092732 2018-08-24 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 406

Signature of
Role Plan administrator
Date 2018-08-24
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-24
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2016 591092732 2017-10-04 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 412

Signature of
Role Plan administrator
Date 2017-10-04
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-04
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
PALM BEACH ATLANTIC UNIVERSITY WELFARE BENEFITS PLAN 2015 591092732 2016-08-11 PALM BEACH ATLANTIC UNIVERSITY 0
File View Page
Three-digit plan number (PN) 506
Effective date of plan 2004-04-01
Business code 611000
Sponsor’s telephone number 5618032000
Plan sponsor’s mailing address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505
Plan sponsor’s address 901 S FLAGLER DR, WEST PALM BEACH, FL, 334016505

Number of participants as of the end of the plan year
Active participants 408
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2016-08-11
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-11
Name of individual signing PAULA HEDAYAT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ILCUS, ANNE Agent 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401

President

Name Role Address
SCHWINN, DEBRA A President 901 S. FLAGLER DR, WEST PALM BEACH, FL 33401

Secretary

Name Role Address
Cotton, Wayne W Secretary 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401

Vice Chairman

Name Role Address
BILL-RABENECKER, CHANDRA Vice Chairman 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401

Treasurer

Name Role Address
STEVENS, MICHAEL J Treasurer 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401

Chief Academic Officer and Provost

Name Role Address
Johnson, Stephen P Chief Academic Officer and Provost 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401

Chief Financial Officer

Name Role Address
Bowie, Stacie A Chief Financial Officer 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401

Chairman

Name Role Address
McCaffrey, Thomas P Chairman 901 S. Flagler Drive, West Palm Beach, FL 33401

Events

Event Type Filed Date Value Description
RESTATED ARTICLES 2022-06-30 No data No data
REGISTERED AGENT NAME CHANGED 2021-11-29 ILCUS, ANNE No data
AMENDMENT 2009-10-13 No data No data
REGISTERED AGENT ADDRESS CHANGED 2009-10-13 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401 No data
CHANGE OF PRINCIPAL ADDRESS 2003-01-24 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401 No data
NAME CHANGE AMENDMENT 2002-07-11 PALM BEACH ATLANTIC UNIVERSITY, INC. No data
AMENDED AND RESTATEDARTICLES 1995-05-22 No data No data
CHANGE OF MAILING ADDRESS 1995-02-24 901 S. FLAGLER DR., WEST PALM BEACH, FL 33401 No data
AMENDMENT 1981-03-16 No data No data
AMENDMENT 1971-02-25 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-24
ANNUAL REPORT 2024-02-09
ANNUAL REPORT 2023-02-10
AMENDED ANNUAL REPORT 2022-07-20
Restated Articles 2022-06-30
ANNUAL REPORT 2022-01-24
AMENDED ANNUAL REPORT 2021-12-06
AMENDED ANNUAL REPORT 2021-11-29
ANNUAL REPORT 2021-04-22
ANNUAL REPORT 2020-05-19

Related by officers

STEVENS, MICHAEL J

RINKER ENTERPRISES, INC. FLOURISH BY NAOMI & MIKE LLC

Related by address

No related companies by address

Date of last update: 06 Feb 2025

Sources: Florida Department of State

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