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  5. EPILEPSY FOUNDATION OF FLORIDA, INC.

EPILEPSY FOUNDATION OF FLORIDA, INC.

Company Details

Entity Name: EPILEPSY FOUNDATION OF FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Inactive
Date Filed: 21 Apr 1972 (53 years ago)
Document Number: 723225
FEI/EIN Number 591412441
Address: 701 E. HILLCREST ST., ORLANDO, FL, 32803, US
Mail Address: 701 E. HILLCREST ST., ORLANDO, FL, 32803, US
ZIP code: 32803
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1770771057 2007-10-11 2009-07-06 7300 N KENDALL DR, 700, MIAMI, FL, 331567840, US 1150 NW 14TH ST, 609, MIAMI, FL, 331362137, US

Contacts
Phone +1 305-670-4949
Fax 3056700904
Phone +1 305-243-5944
Fax 3052437668

Authorized person
Name ANA A HERNANDEZ
Role MEDICAL ADMINISTRATIVE ASSISTANT
Phone 3056704949

Taxonomy
Taxonomy Code 261Q00000X - Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EPILEPSY FOUNDATION OF FLORIDA, INC. 403(B) PLAN 2015 592164525 2017-01-14 EPILEPSY FOUNDATION OF FLORIDA, INC 87
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2017-01-14
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-01-14
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA, INC. 403(B) PLAN 2014 592164525 2016-01-27 EPILEPSY FOUNDATION OF FLORIDA, INC 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2016-01-27
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-01-27
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA, INC. 403(B) PLAN 2013 592164525 2015-03-11 EPILEPSY FOUNDATION OF FLORIDA, INC 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126

Plan administrator’s name and address
Administrator’s EIN 592164525
Plan administrator’s name EPILEPSY FOUNDATION OF FLORIDA, INC
Plan administrator’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126
Administrator’s telephone number 3056704949

Signature of
Role Plan administrator
Date 2015-03-10
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-03-10
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA, INC. 403(B) PLAN 2012 592164525 2014-01-31 EPILEPSY FOUNDATION OF FLORIDA, INC 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126

Plan administrator’s name and address
Administrator’s EIN 592164525
Plan administrator’s name EPILEPSY FOUNDATION OF FLORIDA, INC
Plan administrator’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126
Administrator’s telephone number 3056704949

Signature of
Role Plan administrator
Date 2014-01-31
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-01-31
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA, INC. 403(B) PLAN 2011 592164525 2013-04-15 EPILEPSY FOUNDATION OF FLORIDA, INC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s DBA name EPILEPSY FOUNDATION OF FLORIDA, INC.
Plan sponsor’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126

Plan administrator’s name and address
Administrator’s EIN 592164525
Plan administrator’s name EPILEPSY FOUNDATION OF FLORIDA, INC
Plan administrator’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126
Administrator’s telephone number 3056704949

Signature of
Role Plan administrator
Date 2013-04-15
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-15
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA 403(B) PLAN 2010 592164525 2012-01-30 EPILEPSY FOUNDATION OF FLORIDA 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126

Plan administrator’s name and address
Administrator’s EIN 592164525
Plan administrator’s name EPILEPSY FOUNDATION OF FLORIDA
Plan administrator’s address 1200 NW 78TH AVENUE, SUITE 400, MIAMI, FL, 33126
Administrator’s telephone number 3056704949

Signature of
Role Plan administrator
Date 2012-01-30
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA 403(B) PLAN 2010 592164525 2012-01-27 EPILEPSY FOUNDATION OF FLORIDA 53
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 7300 N KENDALL DRIVE, SUITE 700, MIAMI, FL, 33156

Plan administrator’s name and address
Administrator’s EIN 592164525
Plan administrator’s name EPILEPSY FOUNDATION OF FLORIDA
Plan administrator’s address 7300 N KENDALL DRIVE, SUITE 700, MIAMI, FL, 33156
Administrator’s telephone number 3056704949

Signature of
Role Plan administrator
Date 2012-01-27
Name of individual signing KAREN BASHA EGOZI
Valid signature Filed with authorized/valid electronic signature
EPILEPSY FOUNDATION OF FLORIDA 403(B) PLAN 2009 592164525 2011-04-13 EPILEPSY FOUNDATION OF FLORIDA, INC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 813000
Sponsor’s telephone number 3056704949
Plan sponsor’s address 1200 NW 78TH AVENUE, STE. 400, MIAMI, FL, 33126

Plan administrator’s name and address
Administrator’s EIN 592164525
Plan administrator’s name EPILEPSY FOUNDATION OF FLORIDA, INC
Plan administrator’s address 1200 NW 78TH AVENUE, STE. 400, MIAMI, FL, 33126
Administrator’s telephone number 3056704949

Signature of
Role Plan administrator
Date 2011-04-13
Name of individual signing KAREN EGOZI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FINDLING JANET E Agent 1409 WEKEWA NENE, TALLAHASSEE, FL, 32301

President

Name Role Address
BATES EDRIC R President 2526 NW 55TH BLVD, GAINESVILLE, FL, 32656
GOLD SCOTT President 1317 OAK ST, MELBOURNE, FL, 32951

Secretary

Name Role Address
GRIFFIN ANN Secretary 1601 N.W. 8TH AVE, MIAMI, FL, 33136

Director

Name Role Address
MARTINEZ WALTER Director 1500 N DIXIE HWY #206, W PALM BCH, FL
TURK WILLIAM Director 807 NIRA ST, JACKSONVILLE, FL, 32207

Vice President

Name Role Address
MAYER ROBERT R Vice President 201 S BISCAYNE BLVD, SUITE 2400, MIAMI, FL, 33131

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 1997-09-26 No data No data
NAME CHANGE AMENDMENT 1986-02-25 EPILEPSY FOUNDATION OF FLORIDA, INC. No data

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GOLD SCOTT

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MAYER ROBERT R

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Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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