| Entity Name: | THOMAS C. GIBBS, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Aug 1988 (36 years ago) |
| Document Number: | K31802 |
| FEI/EIN Number | 592906250 |
| Address: | 2775 MEETING PLACE, ORLANDO, FL, 32814, US |
| Mail Address: | 2775 MEETING PLACE, ORLANDO, FL, 32814, US |
| ZIP code: | 32814 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033353628 | 2009-04-27 | 2009-04-27 | 820 LUCERNE TER, ORLANDO, FL, 328013732, US | 820 LUCERNE TER, ORLANDO, FL, 328013732, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 407-648-5101 |
| Fax | 4076488464 |
Authorized person
| Name | DR. THOMAS C. GIBBS |
| Role | OWENER |
| Phone | 4076485101 |
Taxonomy
| Taxonomy Code | 176B00000X - Midwife |
| License Number | ARNP2208682 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207VX0000X - Obstetrics Physician |
| License Number | 0045800 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS C. GIBBS, M.D., P.A. 401(K) PROFIT SHARING PLAN | 2011 | 592906250 | 2012-05-25 | THOMAS C. GIBBS, M.D., P.A. | 10 | |||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 592906250 |
| Plan administrator’s name | THOMAS C. GIBBS, M.D., P.A. |
| Plan administrator’s address | 820 LUCERNE TERRACE, ORLANDO, FL, 32801 |
| Administrator’s telephone number | 4076485101 |
Signature of
| Role | Plan administrator |
| Date | 2012-05-25 |
| Name of individual signing | TATIANA POMBO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2012-05-25 |
| Name of individual signing | TATIANA POMBO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4076485101 |
| Plan sponsor’s address | 820 LUCERNE TERRACE, ORLANDO, FL, 32801 |
Plan administrator’s name and address
| Administrator’s EIN | 592906250 |
| Plan administrator’s name | THOMAS C. GIBBS, M.D., P.A. |
| Plan administrator’s address | 820 LUCERNE TERRACE, ORLANDO, FL, 32801 |
| Administrator’s telephone number | 4076485101 |
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 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1989-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4076485101 |
| Plan sponsor’s address | 820 LUCERNE TERRACE, ORLANDO, FL, 32801 |
Plan administrator’s name and address
| Administrator’s EIN | 592906250 |
| Plan administrator’s name | THOMAS C. GIBBS, M.D., P.A. |
| Plan administrator’s address | 820 LUCERNE TERRACE, ORLANDO, FL, 32801 |
| Administrator’s telephone number | 4076485101 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-23 |
| Name of individual signing | JULIE BURGESS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GIBBS, THOMAS C. | Agent | 2775 MEETING PLACE, ORLANDO, FL, 32814 |
| Name | Role | Address |
|---|---|---|
| GIBBS, THOMAS C. | President | 2775 MEETING PLACE, ORLANDO, FL, 32814 |
| Name | Role | Address |
|---|---|---|
| GIBBS, THOMAS C. | Director | 2775 MEETING PLACE, ORLANDO, FL, 32814 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000582437 | ACTIVE | 2022-CA-010163-O | ORANGE COUNTY, FLORIDA | 2023-11-14 | 2028-11-30 | $228415.21 | NORTH MILL EQUIPMENT FINANCE LLC, 601 MERRITT 7, SUITE 5, NORWALK, CONNECTICUT 06851 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
