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  5. PROVIDER NETWORK SOLUTIONS, LLC

PROVIDER NETWORK SOLUTIONS, LLC

Company Details

Entity Name: PROVIDER NETWORK SOLUTIONS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 31 Jul 2000 (24 years ago)
Document Number: L00000009265
FEI/EIN Number 651027618
Address: 3750 NW 87TH AVENUE, SUITE 500, DORAL, FL, 33178
Mail Address: 3750 NW 87 Avenue, MIAMI, FL, 33178, US
ZIP code: 33178
County: Miami-Dade
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2023 651027618 2024-10-15 PROVIDER NETWORK SOLUTIONS, LLC 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 3750 NW 87TH AVENUE SUITE 500, DORAL, FL, 33178

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2022 651027618 2023-10-16 PROVIDER NETWORK SOLUTIONS, LLC 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2023-10-16
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2021 651027618 2022-10-17 PROVIDER NETWORK SOLUTIONS, LLC 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET STE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2020 651027618 2021-09-27 PROVIDER NETWORK SOLUTIONS, LLC 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2021-09-27
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2019 651027618 2020-10-06 PROVIDER NETWORK SOLUTIONS, LLC 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2020-10-06
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2018 651027618 2019-09-30 PROVIDER NETWORK SOLUTIONS, LLC 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2019-09-30
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2017 651027618 2018-07-19 PROVIDER NETWORK SOLUTIONS, LLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2016 651027618 2017-09-13 PROVIDER NETWORK SOLUTIONS, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2017-09-13
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2015 651027618 2016-10-13 PROVIDER NETWORK SOLUTIONS, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE 115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature
PROVIDER NETWORK SOLUTIONS RETIREMENT PLAN 2014 651027618 2015-10-07 PROVIDER NETWORK SOLUTIONS, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 561790
Sponsor’s telephone number 3052847484
Plan sponsor’s address 8323 NW 12 STREET SUITE115, MIAMI, FL, 33126

Signature of
Role Plan administrator
Date 2015-10-07
Name of individual signing JEREMY GUTERSOHN-MCCOY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Dominguez Jenny Agent 3750 NW 87 AVENUE, MIAMI, FL, 33178

Manager

Name Role Address
JOHNSON RON Manager 3750 NW 87 AVENUE, MIAMI, FL, 33178

Events

Event Type Filed Date Value Description
LC AMENDMENT 2022-09-12 No data No data
LC AMENDMENT AND NAME CHANGE 2013-09-17 PROVIDER NETWORK SOLUTIONS, LLC No data

Related by officers

JOHNSON RON

MEDICAL ACCESS NETWORK, INC. DARK CORPORATION OF TN SIMONTON STREET ASSOCIATION, INC. GENERAL DATA SERVICES, INC. UROLOGY NETWORK SOLUTIONS, LLC MISSING PIECES, INC. ADTEC PRODUCTIONS, INCORPORATED MORTGAGE ASSISTANCE CENTER CORPORATION SOUTHERN STARS INVITATIONAL, INC. KIDS AT PLAY, INC.

Dominguez Jenny

CLAIMS DEVELOPMENT CORPORATION DERMATOLOGY NETWORK SOLUTIONS, LLC ORTHOPEDIX NETWORK SOLUTIONS OF FLORIDA, LLC DERMATOLOGY NETWORK SOLUTIONS OF FLORIDA, LLC PODIATRY NETWORK SOLUTIONS, LLC MILLENNIUM GROUP, LLC NETWORK PHYSICIAN SERVICES, LLC MILLENNIUM ADMIN. SERVICES, LLC NATIONAL PHYSICIANS SERVICES, LLC

Related by address

3750 NW 87TH AVENUE, SUITE 500, DORAL, FL, 33178

PODIATRY NETWORK SOLUTIONS, LLC

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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