Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Brevard
    4. ›
  4. 32796
    5. ›
  5. DAVID N. GREENBLUM, M.D., P.A.

DAVID N. GREENBLUM, M.D., P.A.

Company Details

Entity Name: DAVID N. GREENBLUM, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 15 Oct 1984 (40 years ago)
Date of dissolution: 25 Sep 2015 (9 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (9 years ago)
Document Number: H25757
FEI/EIN Number 59-2453919
Address: % DAVID N. GREENBLUM, M.D., 805 CENTURY MEDICAL DRIVE SUITE C, TITUSVILLE, FL 32796
Mail Address: % DAVID N. GREENBLUM, M.D., 3593 HAMLET PLACE, CHEVY CHASE, MD 20815
ZIP code: 32796
County: Brevard
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVID N. GREENBLUM, M.D., P.A. PROFIT SHARING PLAN 2012 592453919 2013-07-29 DAVID N. GREENBLUM M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-11-01
Business code 621111
Sponsor’s telephone number 3212697659
Plan sponsor’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100

Signature of
Role Plan administrator
Date 2013-07-29
Name of individual signing DAVID N. GREENBLUM
Valid signature Filed with authorized/valid electronic signature
DAVID N. GREENBLUM, M.D., P.A. PROFIT SHARING PLAN 2011 592453919 2012-06-30 DAVID N. GREENBLUM M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-11-01
Business code 621111
Sponsor’s telephone number 3212697659
Plan sponsor’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100

Plan administrator’s name and address
Administrator’s EIN 592453919
Plan administrator’s name DAVID N. GREENBLUM M.D., P.A.
Plan administrator’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100
Administrator’s telephone number 3212697659

Signature of
Role Plan administrator
Date 2012-06-30
Name of individual signing DAVID N. GREENBLUM
Valid signature Filed with authorized/valid electronic signature
DAVID N. GREENBLUM, M.D., P.A. PROFIT SHARING PLAN 2010 592453919 2011-09-21 DAVID N. GREENBLUM M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-11-01
Business code 621111
Sponsor’s telephone number 3212697659
Plan sponsor’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100

Plan administrator’s name and address
Administrator’s EIN 592453919
Plan administrator’s name DAVID N. GREENBLUM M.D., P.A.
Plan administrator’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100
Administrator’s telephone number 3212697659

Signature of
Role Plan administrator
Date 2011-09-21
Name of individual signing DAVID N. GREENBLUM
Valid signature Filed with authorized/valid electronic signature
DAVID N. GREENBLUM, M.D., P.A. PROFIT SHARING PLAN 2009 592453919 2010-07-21 DAVID N. GREENBLUM M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-11-01
Business code 621111
Sponsor’s telephone number 3212697659
Plan sponsor’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100

Plan administrator’s name and address
Administrator’s EIN 592453919
Plan administrator’s name DAVID N. GREENBLUM M.D., P.A.
Plan administrator’s address 805 CENTURY MEDICAL DRIVE, TITUSVILLE, FL, 327962100
Administrator’s telephone number 3212697659

Signature of
Role Plan administrator
Date 2010-07-21
Name of individual signing DAVID N. GREENBLUM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GREENBLUM, DAVID N., M.D. Agent 805 CENTURY MEDICAL DR., SUITE C, TITUSVILLE, FL 32796

President

Name Role Address
GREENBLUM, DAVID N., MD President 3593 HAMLET PLACE, CHEVY CHASE, MD 20815

Secretary

Name Role Address
GREENBLUM, DAVID N., MD Secretary 3593 HAMLET PLACE, CHEVY CHASE, MD 20815

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
CHANGE OF MAILING ADDRESS 2014-02-01 % DAVID N. GREENBLUM, M.D., 805 CENTURY MEDICAL DRIVE SUITE C, TITUSVILLE, FL 32796 No data
CHANGE OF PRINCIPAL ADDRESS 2010-01-04 % DAVID N. GREENBLUM, M.D., 805 CENTURY MEDICAL DRIVE SUITE C, TITUSVILLE, FL 32796 No data
REGISTERED AGENT ADDRESS CHANGED 2008-03-07 805 CENTURY MEDICAL DR., SUITE C, TITUSVILLE, FL 32796 No data

Documents

Name Date
ANNUAL REPORT 2014-02-01
ANNUAL REPORT 2013-03-31
ANNUAL REPORT 2012-03-02
ANNUAL REPORT 2011-02-15
ANNUAL REPORT 2010-01-04
ANNUAL REPORT 2009-03-05
ANNUAL REPORT 2008-03-07
ANNUAL REPORT 2007-02-06
ANNUAL REPORT 2006-01-22
ANNUAL REPORT 2005-01-06

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 04 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated