| Entity Name: | PALM BEACH HEART GROUP, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 08 Jul 1983 (42 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | G48923 |
| FEI/EIN Number | 59-2306781 |
| Address: | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 |
| Mail Address: | P.O.BOX 31988, PALM BEACH GARDENS, FL 33420 |
| ZIP code: | 33408 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487779153 | 2007-03-20 | 2010-07-28 | 3370 BURNS RD, SUITE 106, PALM BEACH GARDENS, FL, 334104327, US | 3370 BURNS RD, SUITE 106, PALM BEACH GARDENS, FL, 334104327, US | |||||||||||||||||||
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| Phone | +1 561-622-3875 |
| Fax | 5616224614 |
Authorized person
| Name | DR. EDGAR ANGEL COVARRUBIAS |
| Role | PHYSICIAN |
| Phone | 5616223875 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME 36593 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PALM BEACH HEART GROUP, P.A. PROFIT SHARING TRUST AND 401K PLAN | 2010 | 592306781 | 2010-10-14 | PALM BEACH HEART GROUP, P.A. | 4 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 592306781 |
| Plan administrator’s name | PALM BEACH HEART GROUP, P.A. |
| Plan administrator’s address | 3370 BURNS ROAD, SUITE106, PALM BEACH GARDENS, FL, 33410 |
| Administrator’s telephone number | 5616223875 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-14 |
| Name of individual signing | EDGAR COVARRUBIAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1985-07-13 |
| Business code | 621111 |
| Sponsor’s telephone number | 5616223875 |
| Plan sponsor’s address | 3370 BURNS ROAD, SUITE106, PALM BEACH GARDENS, FL, 33410 |
Plan administrator’s name and address
| Administrator’s EIN | 592306781 |
| Plan administrator’s name | PALM BEACH HEART GROUP, P.A. |
| Plan administrator’s address | 3370 BURNS ROAD, SUITE106, PALM BEACH GARDENS, FL, 33410 |
| Administrator’s telephone number | 5616223875 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-11 |
| Name of individual signing | EDGAR A. COVARRUBIAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| COVARRUBIAS, EDGAR A | Agent | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 |
| Name | Role | Address |
|---|---|---|
| COVARRUBIAS, EDGAR | President | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 |
| Name | Role | Address |
|---|---|---|
| COVARRUBIAS, EDGAR | Secretary | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 |
| Name | Role | Address |
|---|---|---|
| COVARRUBIAS, EDGAR | Treasurer | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-17 | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-17 | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-17 | COVARRUBIAS, EDGAR A | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-17 | 149 BOWSPRIT DRIVE, NORTH PALM BEACH, FL 33408 | No data |
| NAME CHANGE AMENDMENT | 1995-12-07 | PALM BEACH HEART GROUP, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-17 |
| ANNUAL REPORT | 2012-04-09 |
| ANNUAL REPORT | 2011-02-21 |
| ANNUAL REPORT | 2010-02-15 |
| ANNUAL REPORT | 2009-01-16 |
| ANNUAL REPORT | 2008-01-07 |
| ANNUAL REPORT | 2007-01-09 |
| ANNUAL REPORT | 2006-03-10 |
| ANNUAL REPORT | 2005-02-25 |
| ANNUAL REPORT | 2004-04-23 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
