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RETINA ASSOCIATES OF FLORIDA, P.A.

Company Details

Entity Name: RETINA ASSOCIATES OF FLORIDA, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 29 Aug 1986 (38 years ago)
Date of dissolution: 30 Oct 2014 (10 years ago)
Last Event: CONVERSION
Event Date Filed: 30 Oct 2014 (10 years ago)
Document Number: J31174
FEI/EIN Number 59-2695288
Address: 602 S. MACDILL AVE., TAMPA, FL 33609-4614
Mail Address: 602 S. MACDILL AVE., TAMPA, FL 33609-4614
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1811959570 2006-04-06 2010-04-01 602 S MACDILL AVENUE, TAMPA, FL, 336094614, US 602 S MACDILL AVENUE, TAMPA, FL, 336094614, US

Contacts
Phone +1 813-875-6373
Fax 8138760960

Authorized person
Name DR. MARK E HAMMER
Role DOCTOR
Phone 8138756373

Taxonomy
Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes

Other Provider Identifiers
Issuer BCBS
Number 38722
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RETINA ASSOCIATES OF FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2013 592695288 2014-06-16 RETINA ASSOCIATES OF FLORIDA, P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-09-01
Business code 621111
Sponsor’s telephone number 8138758801
Plan sponsor’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614

Signature of
Role Plan administrator
Date 2014-06-16
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-16
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
RETINA ASSOCIATES OF FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2012 592695288 2013-05-03 RETINA ASSOCIATES OF FLORIDA, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-09-01
Business code 621111
Sponsor’s telephone number 8138758801
Plan sponsor’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614

Signature of
Role Plan administrator
Date 2013-05-03
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-03
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
RETINA ASSOCIATES OF FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2011 592695288 2012-03-19 RETINA ASSOCIATES OF FLORIDA, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-09-01
Business code 621111
Sponsor’s telephone number 8138758801
Plan sponsor’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614

Plan administrator’s name and address
Administrator’s EIN 592695288
Plan administrator’s name RETINA ASSOCIATES OF FLORIDA, P.A.
Plan administrator’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614
Administrator’s telephone number 8138758801

Signature of
Role Plan administrator
Date 2012-03-19
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-19
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
RETINA ASSOCIATES OF FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2010 592695288 2011-05-19 RETINA ASSOCIATES OF FLORIDA, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-09-01
Business code 621111
Sponsor’s telephone number 8138758801
Plan sponsor’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614

Plan administrator’s name and address
Administrator’s EIN 592695288
Plan administrator’s name RETINA ASSOCIATES OF FLORIDA, P.A.
Plan administrator’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614
Administrator’s telephone number 8138758801

Signature of
Role Plan administrator
Date 2011-05-19
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-05-19
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
RETINA ASSOCIATES OF FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2009 592695288 2010-07-08 RETINA ASSOCIATES OF FLORIDA, P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-09-01
Business code 621111
Sponsor’s telephone number 8138758801
Plan sponsor’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614

Plan administrator’s name and address
Administrator’s EIN 592695288
Plan administrator’s name RETINA ASSOCIATES OF FLORIDA, P.A.
Plan administrator’s address 602 SOUTH MACDILL AVENUE, TAMPA, FL, 336094614
Administrator’s telephone number 8138758801

Signature of
Role Plan administrator
Date 2010-07-08
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-08
Name of individual signing MARK E. HAMMER, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HAMMER, MARK EMD Agent 602 S. MACDILL AVE, TAMPA, FL 33609-4614

President

Name Role Address
HAMMER, MARK EMD President 602 S. MACDILL AVE, TAMPA, FL 33609-4614

Secretary

Name Role Address
Suner, Ivan J, M.D. Secretary 602 S. MACDILL AVE., TAMPA, FL 33609-4614

Treasurer

Name Role Address
Suner, Ivan J, M.D. Treasurer 602 S. MACDILL AVE., TAMPA, FL 33609-4614

Events

Event Type Filed Date Value Description
CONVERSION 2014-10-30 No data CONVERSION MEMBER. RESULTING CORPORATION WAS L14000169628. CONVERSION NUMBER 100000145891
REGISTERED AGENT NAME CHANGED 2012-04-13 HAMMER, MARK EMD No data
CHANGE OF PRINCIPAL ADDRESS 2009-04-14 602 S. MACDILL AVE., TAMPA, FL 33609-4614 No data
CHANGE OF MAILING ADDRESS 2009-04-14 602 S. MACDILL AVE., TAMPA, FL 33609-4614 No data
REGISTERED AGENT ADDRESS CHANGED 2006-03-02 602 S. MACDILL AVE, TAMPA, FL 33609-4614 No data
NAME CHANGE AMENDMENT 1991-07-31 RETINA ASSOCIATES OF FLORIDA, P.A. No data
NAME CHANGE AMENDMENT 1991-04-22 RETINAL ASSOCIATES OF FLORIDA, P.A. No data

Documents

Name Date
ANNUAL REPORT 2014-04-08
ANNUAL REPORT 2013-03-06
ANNUAL REPORT 2012-04-13
ANNUAL REPORT 2011-04-25
ANNUAL REPORT 2010-04-22
ANNUAL REPORT 2009-04-14
ANNUAL REPORT 2008-04-23
ANNUAL REPORT 2007-04-19
ANNUAL REPORT 2006-03-02
ANNUAL REPORT 2005-03-29

Related by officers

HAMMER, MARK EMD

VISIONARY HEALTH SERVICES, INC.

Related by address

No related companies by address

Date of last update: 04 Feb 2025

Sources: Florida Department of State

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