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  5. ADULT UROLOGY CLINIC, P.A.

ADULT UROLOGY CLINIC, P.A.

Company Details

Entity Name: ADULT UROLOGY CLINIC, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 05 Apr 1985 (40 years ago)
Document Number: H50889
FEI/EIN Number 592515452
Address: 3375 Burns Road, Palm Beach Gardens, FL, 33410, US
Mail Address: 3375 Burns Road, Palm Beach Gardens, FL, 33410, US
ZIP code: 33410
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADULT UROLOGY CLINIC, P.A. PROFIT SHARING PLAN 2012 592515452 2013-05-17 ADULT UROLOGY CLINIC, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 5617475885
Plan sponsor’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458

Signature of
Role Plan administrator
Date 2013-05-17
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-17
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
ADULT UROLOGY CLINIC, P.A. PROFIT SHARING PLAN 2011 592515452 2012-07-11 ADULT UROLOGY CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 5617475885
Plan sponsor’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 592515452
Plan administrator’s name ADULT UROLOGY CLINIC, P.A.
Plan administrator’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458
Administrator’s telephone number 5617475885

Signature of
Role Plan administrator
Date 2012-07-11
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-11
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
ADULT UROLOGY CLINIC, P.A. PROFIT SHARING PLAN 2010 592515452 2011-07-13 ADULT UROLOGY CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 5617475885
Plan sponsor’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 592515452
Plan administrator’s name ADULT UROLOGY CLINIC, P.A.
Plan administrator’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458
Administrator’s telephone number 5617475885

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-13
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
ADULT UROLOGY CLINIC, P.A. PROFIT SHARING PLAN 2009 592515452 2010-08-17 ADULT UROLOGY CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 5617475885
Plan sponsor’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 592515452
Plan administrator’s name ADULT UROLOGY CLINIC, P.A.
Plan administrator’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458
Administrator’s telephone number 5617475885

Signature of
Role Plan administrator
Date 2010-08-17
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-17
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
ADULT UROLOGY CLINIC, P.A. PROFIT SHARING PLAN 2009 592515452 2010-08-17 ADULT UROLOGY CLINIC, P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 5617475885
Plan sponsor’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 592515452
Plan administrator’s name ADULT UROLOGY CLINIC, P.A.
Plan administrator’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458
Administrator’s telephone number 5617475885

Signature of
Role Plan administrator
Date 2010-08-17
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-17
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
ADULT UROLOGY CLINIC, P.A. PROFIT SHARING PLAN 2009 592515452 2010-07-06 ADULT UROLOGY CLINIC, P.A. 7
Three-digit plan number (PN) 002
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 5617475885
Plan sponsor’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458

Plan administrator’s name and address
Administrator’s EIN 592515452
Plan administrator’s name ADULT UROLOGY CLINIC, P.A.
Plan administrator’s address 1002 S. OLD DIXIE HWY., SUITE 104, JUPITER, FL, 33458
Administrator’s telephone number 5617475885

Signature of
Role Plan administrator
Date 2010-07-06
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-06
Name of individual signing BRUCE E. WIITA, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WIITA BRUCE Dr. Agent 3375 Burns Road, Palm Beach Gardens, FL, 33410

Director

Name Role Address
WIITA, BRUCE E. Director 3375 Burns Road, Palm Beach Gardens, FL, 33410

President

Name Role Address
WIITA, BRUCE E. President 3375 Burns Road, Palm Beach Gardens, FL, 33410

Events

Event Type Filed Date Value Description
REINSTATEMENT 2019-05-08 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 No data No data
AMENDMENT 2005-01-26 No data No data
CANCEL ADM DISS/REV 2004-11-23 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2004-10-01 No data No data
NAME CHANGE AMENDMENT 2004-01-29 ADULT UROLOGY CLINIC, P.A. No data
NAME CHANGE AMENDMENT 1994-02-01 ADULT & PEDIATRIC UROLOGY CLINIC, P.A. No data

Related by officers

WIITA, BRUCE E.

AMERICAN HERITAGE I, INC. JUPITER MEDICAL CORPORATION PLAZA NORTH MEDICAL CENTER, LTD. JUPITER MEDICAL PARK, INC. BRUCE E. WIITA, M.D., P.A.

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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