| Entity Name: | MANATEE SURGICAL SPECIALISTS, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 01 Oct 1982 (42 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | G01410 |
| FEI/EIN Number | 59-2220041 |
| Address: | 201 4TH AVE EAST, SUITE 2, BRADENTON, FL 34208 |
| Mail Address: | 201 4TH AVE EAST, SUITE 2, BRADENTON, FL 34208 |
| ZIP code: | 34208 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295811123 | 2006-10-31 | 2013-01-10 | 201 4TH AVE E, SUITE 2, BRADENTON, FL, 342081043, US | 201 4TH AVE E, SUITE 2, BRADENTON, FL, 342081043, US | |||||||||||||||||||||||||
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| Phone | +1 941-748-6099 |
| Fax | 9417475061 |
Authorized person
| Name | DR. A. SAMIR HASSAN |
| Role | PRESIDENT |
| Phone | 9417486099 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME37646 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE FLORIDA |
| Number | CH3341 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A SAMIR HASSAN MD PA PROFIT SHARING PLAN | 2010 | 592220041 | 2011-09-28 | MANATEE SURGICAL SPECIALISTS PA | 4 | |||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 592220041 |
| Plan administrator’s name | MANATEE SURGICAL SPECIALISTS PA |
| Plan administrator’s address | 201 4TH AVE E STE 2, BRADENTON, FL, 34208 |
Signature of
| Role | Plan administrator |
| Date | 2011-09-28 |
| Name of individual signing | A. SAMIR HASSAN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-09-28 |
| Name of individual signing | A. SAMIR HASSAN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1983-10-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9417486099 |
| Plan sponsor’s address | 201 4TH AVE E STE 2, BRADENTON, FL, 34208 |
Plan administrator’s name and address
| Administrator’s EIN | 592220041 |
| Plan administrator’s name | MANATEE SURGICAL SPECIALISTS PA |
| Plan administrator’s address | 201 4TH AVE E STE 2, BRADENTON, FL, 34208 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-11 |
| Name of individual signing | A. SAMIR HASSAN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-10-11 |
| Name of individual signing | A. SAMIR HASSAN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| HASSAN A. SAMIR | Agent | 201 4TH AVE E STE 2, SUITE 2, BRADENTON, FL 34208 |
| Name | Role | Address |
|---|---|---|
| HASSAN, A. SAMIR | President | 201 4TH AVE EAST, SUITE 2 BRADENTON, FL 34208 |
| Name | Role | Address |
|---|---|---|
| HASSAN, A. SAMIR | Secretary | 201 4TH AVE EAST, SUITE 2 BRADENTON, FL 34208 |
| Name | Role | Address |
|---|---|---|
| HASSAN, A. SAMIR | Treasurer | 201 4TH AVE EAST, SUITE 2 BRADENTON, FL 34208 |
| Name | Role | Address |
|---|---|---|
| Hassan, A Samir | Director | 201 4TH AVE EAST, SUITE 2 BRADENTON, FL 34208 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-14 | 201 4TH AVE EAST, SUITE 2, BRADENTON, FL 34208 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-03-09 | 201 4TH AVE E STE 2, SUITE 2, BRADENTON, FL 34208 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-03-09 | 201 4TH AVE EAST, SUITE 2, BRADENTON, FL 34208 | No data |
| NAME CHANGE AMENDMENT | 1997-04-14 | MANATEE SURGICAL SPECIALISTS, PA | No data |
| NAME CHANGE AMENDMENT | 1985-05-21 | A. SAMIR HASSAN, M.D., P.A. | No data |
| NAME CHANGE AMENDMENT | 1984-11-08 | HASSAN & ESTIGARRIBIA, M.D.'S, P.A. | No data |
| NAME CHANGE AMENDMENT | 1984-03-30 | HASSAN & ESTIGARIBA, M.D.'S, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-03-25 |
| ANNUAL REPORT | 2014-04-23 |
| ANNUAL REPORT | 2013-03-21 |
| ANNUAL REPORT | 2012-02-14 |
| ANNUAL REPORT | 2011-03-25 |
| ANNUAL REPORT | 2010-02-11 |
| ANNUAL REPORT | 2009-04-27 |
| ANNUAL REPORT | 2008-04-22 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
