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  5. HAROLD H. ROSEN, M.D., P.A.

HAROLD H. ROSEN, M.D., P.A.

Company Details

Entity Name: HAROLD H. ROSEN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 21 Nov 1988 (36 years ago)
Document Number: K46373
FEI/EIN Number 650085794
Address: 1 WEST SAMPLE RD., SUITE 102, POMPANO BCH., FL, 33064, US
Mail Address: 1 WEST SAMPLE RD., SUITE 102, POMPANO BCH., FL, 33064, US
ZIP code: 33064
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598020745 2012-07-12 2012-07-12 1 W SAMPLE RD, #102, POMPANO BEACH, FL, 330643547, US 1 W SAMPLE RD, #102, POMPANO BEACH, FL, 330643547, US

Contacts
Phone +1 954-782-2442
Fax 9547822502

Authorized person
Name DR. HAROLD HARVEY ROSEN
Role MD
Phone 9547822442

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HAROLD H. ROSEN, M.D. PROFIT SHARING PLAN 2011 650085794 2012-02-14 HAROLD H. ROSEN, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 9547822442
Plan sponsor’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064

Plan administrator’s name and address
Administrator’s EIN 650085794
Plan administrator’s name HAROLD H. ROSEN, M.D., P.A.
Plan administrator’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064
Administrator’s telephone number 9547822442

Signature of
Role Plan administrator
Date 2012-02-14
Name of individual signing CAMERON KELLY
Valid signature Filed with authorized/valid electronic signature
HAROLD H. ROSEN, M.D. PROFIT SHARING PLAN 2010 650085794 2011-12-28 HAROLD H. ROSEN, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 9547822442
Plan sponsor’s mailing address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064
Plan sponsor’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064

Plan administrator’s name and address
Administrator’s EIN 650085794
Plan administrator’s name HAROLD H. ROSEN, M.D., P.A.
Plan administrator’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064
Administrator’s telephone number 9547822442

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 2
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 4
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-12-28
Name of individual signing CAMERON KELLY
Valid signature Filed with authorized/valid electronic signature
HAROLD H. ROSEN, M.D. PROFIT SHARING PLAN 2010 650085794 2011-12-28 HAROLD H. ROSEN, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 9547822442
Plan sponsor’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064

Plan administrator’s name and address
Administrator’s EIN 650085794
Plan administrator’s name HAROLD H. ROSEN, M.D., P.A.
Plan administrator’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE, ROAD, SUITE 102, POMPANO BEACH, FL, 33064
Administrator’s telephone number 9547822442

Signature of
Role Plan administrator
Date 2011-12-28
Name of individual signing CAMERON KELLY
Valid signature Filed with authorized/valid electronic signature
HAROLD H. ROSEN, M.D. PROFIT SHARING PLAN 2009 650085794 2011-12-28 HAROLD H. ROSEN, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-01-01
Business code 621111
Sponsor’s telephone number 9547822442
Plan sponsor’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE ROAD, SUITE 102, POMPANO BEACH, FL, 33064

Plan administrator’s name and address
Administrator’s EIN 650085794
Plan administrator’s name HAROLD H. ROSEN, M.D., P.A.
Plan administrator’s address ONE MEDICAL PLAZA, ONE WEST SAMPLE ROAD, SUITE 102, POMPANO BEACH, FL, 33064
Administrator’s telephone number 9547822442

Signature of
Role Plan administrator
Date 2011-12-28
Name of individual signing CAMERON KELLY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ZUCKERMAN, LESLIE H. Agent 4000 HOLLYWOOD BLVD STE 485, HOLLYWOOD, FL, 00000

Director

Name Role Address
ROSEN HAROLD H Director 1 WEST SAMPLE RD., POMPANO BCH., FL, 33064

Related by officers

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ZUCKERMAN, LESLIE H.

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Related by address

No related companies by address

Date of last update: 01 Jan 2025

Sources: Florida Department of State

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