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  5. SCOTT E. FARBER, D.D.S., P.A.

SCOTT E. FARBER, D.D.S., P.A.

Company Details

Entity Name: SCOTT E. FARBER, D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 22 Sep 1986 (38 years ago)
Date of dissolution: 25 Sep 2020 (4 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2020 (4 years ago)
Document Number: J34231
FEI/EIN Number 59-2715085
Address: 1734 BILLINGSHURST COURT, ORLANDO, FL 32825
Mail Address: 1734 BILLINGSHURST COURT, ORLANDO, FL 32825
ZIP code: 32825
County: Orange
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043582331 2012-02-01 2012-02-01 5150 CURRY FORD RD, ORLANDO, FL, 328128744, US 5150 CURRY FORD RD, ORLANDO, FL, 328128744, US

Contacts
Phone +1 407-282-3304
Fax 4073805486

Authorized person
Name DR. SCOTT ELLIOTT FARBER
Role PRESIDENT
Phone 4072823304

Taxonomy
Taxonomy Code 204E00000X - Oral & Maxillofacial Surgery (D.M.D.)
License Number DN0010034
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICARE PROVIDER # 60586 FLORIDA
Number T85347
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2015 592715085 2016-08-11 SCOTT E. FARBER, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 1734 BILLINGSHURST COURT, ORLANDO, FL, 32825
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2015 592715085 2016-08-11 SCOTT E. FARBER, D.D.S., P.A. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 1734 BILLINGSHURST COURT, ORLANDO, FL, 32825
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2014 592715085 2015-08-21 SCOTT E. FARBER, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2013 592715085 2014-08-28 SCOTT E. FARBER, D.D.S., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2012 592715085 2013-08-02 SCOTT E. FARBER, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812

Signature of
Role Plan administrator
Date 2013-08-02
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-02
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2011 592715085 2012-09-19 SCOTT E. FARBER, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812

Plan administrator’s name and address
Administrator’s EIN 592715085
Plan administrator’s name SCOTT E. FARBER, D.D.S., P.A.
Plan administrator’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812
Administrator’s telephone number 4072823304

Signature of
Role Plan administrator
Date 2012-09-19
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-19
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2010 592715085 2011-06-16 SCOTT E. FARBER, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812

Plan administrator’s name and address
Administrator’s EIN 592715085
Plan administrator’s name SCOTT E. FARBER, D.D.S., P.A.
Plan administrator’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812
Administrator’s telephone number 4072823304

Signature of
Role Plan administrator
Date 2011-06-16
Name of individual signing TATIANA CHAVEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-16
Name of individual signing TATIANA CHAVEZ
Valid signature Filed with authorized/valid electronic signature
SCOTT E. FARBER, D.D.S., P.A. 401(K) PROFIT SHARING PLAN 2009 592715085 2010-09-02 SCOTT E. FARBER, D.D.S., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621210
Sponsor’s telephone number 4072823304
Plan sponsor’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812

Plan administrator’s name and address
Administrator’s EIN 592715085
Plan administrator’s name SCOTT E. FARBER, D.D.S., P.A.
Plan administrator’s address 5150 CURRY FORD ROAD, ORLANDO, FL, 32812
Administrator’s telephone number 4072823304

Signature of
Role Plan administrator
Date 2010-09-02
Name of individual signing JULIE BURGESS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FARBER, SCOTT E Agent 1734 BILLINGSHURST COURT, ORLANDO, FL 32825

President

Name Role Address
FARBER, SCOTT E President 1734 BILLINGSHURST COURT, ORLANDO, FL 32825

Director

Name Role Address
FARBER, SCOTT E Director 1734 BILLINGSHURST COURT, ORLANDO, FL 32825

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2016-04-13 1734 BILLINGSHURST COURT, ORLANDO, FL 32825 No data
CHANGE OF MAILING ADDRESS 2016-04-13 1734 BILLINGSHURST COURT, ORLANDO, FL 32825 No data
REGISTERED AGENT ADDRESS CHANGED 2016-04-13 1734 BILLINGSHURST COURT, ORLANDO, FL 32825 No data
REGISTERED AGENT NAME CHANGED 2006-04-28 FARBER, SCOTT E No data
REINSTATEMENT 1996-09-20 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 1996-08-23 No data No data

Documents

Name Date
ANNUAL REPORT 2019-02-01
ANNUAL REPORT 2018-03-01
ANNUAL REPORT 2017-03-14
ANNUAL REPORT 2016-04-13
ANNUAL REPORT 2015-02-04
ANNUAL REPORT 2014-02-21
ANNUAL REPORT 2013-04-12
ANNUAL REPORT 2012-04-06
ANNUAL REPORT 2011-01-10
ANNUAL REPORT 2010-04-09

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

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