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  5. PALM BEACH SURGICAL ASSOCIATES, LLC

PALM BEACH SURGICAL ASSOCIATES, LLC

Company Details

Entity Name: PALM BEACH SURGICAL ASSOCIATES, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 11 Dec 2003 (21 years ago)
Date of dissolution: 21 Apr 2023 (2 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 21 Apr 2023 (2 years ago)
Document Number: L03000052374
FEI/EIN Number 650450956
Address: 12955 Palms West Dr., STE 101, Loxahatchee, FL, 33470, US
Mail Address: 12955 Palms West Dr., STE 101, Loxahatchee, FL, 33470, US
ZIP code: 33470
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2021 650450956 2022-06-30 PALM BEACH SURGICAL ASSOCIATES, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-10
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 12955 PALMS WEST DRIVE, SUITE 101, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2021 650450956 2022-06-30 PALM BEACH SURGICAL ASSOCIATES, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-10
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 12955 PALMS WEST DRIVE, SUITE 101, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2020 650450956 2021-06-21 PALM BEACH SURGICAL ASSOCIATES, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-10
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 12955 PALMS WEST DRIVE, SUITE 101, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2019 650450956 2020-07-10 PALM BEACH SURGICAL ASSOCIATES, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-10
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 12955 PALMS WEST DRIVE, SUITE 101, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2018 650450956 2019-05-03 PALM BEACH SURGICAL ASSOCIATES, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 12955 PALMS WEST DRIVE, SUITE 101, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2017 650450956 2018-07-09 PALM BEACH SURGICAL ASSOCIATES, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5619642211
Plan sponsor’s address 12955 PALMS WEST DRIVE SUITE 101, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2016 650450956 2017-10-10 PALM BEACH SURGICAL ASSOCIATES, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5619642211
Plan sponsor’s address 12955 PALMS WEST DRIVE SUITE 100, LOXAHATCHEE, FL, 33470
PALM BEACH SURGICAL ASSOCIATES 401(K) PLAN 2015 650450956 2016-10-13 PALM BEACH SURGICAL ASSOCIATES, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5619642211
Plan sponsor’s address 1397 MEDICAL PARK BLVD, SUITE 100, WELLINGTON, FL, 33414
PALM BEACH SURGICAL ASSOCIATES 401K PLAN 2014 650450956 2015-07-10 PALM BEACH SURGICAL ASSOCIATES, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 1397 MEDICAL PARK BLVD, STE. 100, WELLINGTON, FL, 33414

Signature of
Role Plan administrator
Date 2015-07-10
Name of individual signing JACK ZELTZER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-10
Name of individual signing JACK ZELTZER
Valid signature Filed with authorized/valid electronic signature
PALM BEACH SURGICAL ASSOCIATES 401K PLAN 2013 650450956 2014-07-03 PALM BEACH SURGICAL ASSOCIATES, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5617981515
Plan sponsor’s address 1397 MEDICAL PARK BLVD, STE. 100, WELLINGTON, FL, 33414

Signature of
Role Plan administrator
Date 2014-07-03
Name of individual signing JACK ZELTZER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-03
Name of individual signing JACK ZELTZER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SAUERBERG ERIC M Agent 200 VILLAGE SQARE CROSSING, PALM BEACH GARDENS, FL, 33410

Managing Member

Name Role Address
CHIDAMBARAM ARUL B Managing Member 12955 Palms West Dr., Loxahatchee, FL, 33470

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2023-04-21 No data No data
CHANGE OF PRINCIPAL ADDRESS 2017-04-25 12955 Palms West Dr., STE 101, Loxahatchee, FL 33470 No data
CHANGE OF MAILING ADDRESS 2017-04-25 12955 Palms West Dr., STE 101, Loxahatchee, FL 33470 No data
CANCEL ADM DISS/REV 2010-03-18 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data
MERGER 2003-12-24 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 0. MERGER NUMBER 700000047427

Documents

Name Date
VOLUNTARY DISSOLUTION 2023-04-21
AMENDED ANNUAL REPORT 2022-04-04
ANNUAL REPORT 2022-02-08
ANNUAL REPORT 2021-02-05
ANNUAL REPORT 2020-03-17
ANNUAL REPORT 2019-03-15
ANNUAL REPORT 2018-04-06
ANNUAL REPORT 2017-04-25
ANNUAL REPORT 2016-03-10
ANNUAL REPORT 2015-02-23

Related by officers

CHIDAMBARAM ARUL B

CACJ, LLC. ARUL B. CHIDAMBARAM, M.D., P.A. ACEA, LLC

SAUERBERG ERIC M

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Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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