| Entity Name: | AMIR H. FATEMI, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 01 May 1982 (43 years ago) |
| Date of dissolution: | 11 May 2009 (16 years ago) |
| Last Event: | CONVERSION |
| Event Date Filed: | 11 May 2009 (16 years ago) |
| Document Number: | F77105 |
| FEI/EIN Number | 59-2191237 |
| Address: | 6934 ST. AUGUSTINE ROAD, JACKSONVILLE, FL 32217 |
| Mail Address: | 8853 SAN JOSE BLVD, SUITE 310, JACKSONVILLE, FL 32217 |
| ZIP code: | 32217 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMIR H. FATEMI, M.D.P.A. PROFIT SHARING PLAN | 2011 | 592191237 | 2012-11-29 | AMIR H. FATEMI, M.D.P.A. | 1 | |||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 592191237 |
| Plan administrator’s name | AMIR H FATEMI MD PA |
| Plan administrator’s address | 6934 ST AUGUSTINE ROAD, JACKSONVILLE, FL, 32217 |
Number of participants as of the end of the plan year
| Active participants | 1 |
| Number of participants with account balances as of the end of the plan year | 1 |
Signature of
| Role | Plan administrator |
| Date | 2012-12-20 |
| Name of individual signing | AMIR H FATEMI MD |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1985-05-01 |
| Business code | 621111 |
| Plan sponsor’s mailing address | 6934 ST. AUGUSTINE RD., JACKSONVILLE, FL, 32217 |
| Plan sponsor’s address | 6934 ST AUGUSTINE RD, JACKSONVILLE, FL, 32217 |
Plan administrator’s name and address
| Administrator’s EIN | 592191237 |
| Plan administrator’s name | AMIR H FATEMI MD PA |
| Plan administrator’s address | 6934 ST AUGUSTINE ROAD, JACKSONVILLE, FL, 32217 |
Number of participants as of the end of the plan year
| Active participants | 1 |
| Number of participants with account balances as of the end of the plan year | 1 |
Signature of
| Role | Plan administrator |
| Date | 2011-12-07 |
| Name of individual signing | AMIR H FATEMI MD |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ALBRAHAM I BATEH, P.A. | Agent | 1558 SAN MARCO BLVD., JACKSONVILLE, FL 32207 |
| Name | Role | Address |
|---|---|---|
| FATEMI, MAHSHID | Secretary | 6934 ST. AUGUSTINE ROAD, JACKSONVILLE, FL 32217 |
| Name | Role | Address |
|---|---|---|
| FATEMI, MAHSHID | Treasurer | 6934 ST. AUGUSTINE ROAD, JACKSONVILLE, FL 32217 |
| Name | Role | Address |
|---|---|---|
| FATEMI, AMIR HM.D. | President | 6934 ST AUGUSTINE RD, JACKSONVILLE, FL 32217 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2009-05-11 | No data | CONVERSION MEMBER. RESULTING CORPORATION WAS L09000046413. CONVERSION NUMBER 700000096647 |
| REGISTERED AGENT NAME CHANGED | 2008-08-21 | ALBRAHAM I BATEH, P.A. | No data |
| CANCEL ADM DISS/REV | 2007-12-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| CANCEL ADM DISS/REV | 2005-08-17 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-08-17 | 1558 SAN MARCO BLVD., JACKSONVILLE, FL 32207 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2002-04-29 | 6934 ST. AUGUSTINE ROAD, JACKSONVILLE, FL 32217 | No data |
| CHANGE OF MAILING ADDRESS | 2002-04-29 | 6934 ST. AUGUSTINE ROAD, JACKSONVILLE, FL 32217 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-04-20 |
| Reg. Agent Change | 2008-08-21 |
| ANNUAL REPORT | 2008-03-26 |
| REINSTATEMENT | 2007-12-13 |
| REINSTATEMENT | 2005-08-17 |
| Reg. Agent Resignation | 2004-01-23 |
| ANNUAL REPORT | 2003-05-01 |
| ANNUAL REPORT | 2002-04-29 |
| ANNUAL REPORT | 2001-04-25 |
| ANNUAL REPORT | 2000-05-09 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
