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  5. FARAHMAND PLASTIC SURGERY, P.L.

FARAHMAND PLASTIC SURGERY, P.L.

Company Details

Entity Name: FARAHMAND PLASTIC SURGERY, P.L.
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 21 Mar 2005 (20 years ago)
Document Number: L05000027897
FEI/EIN Number 202539348
Address: 12411 BRANTLEY COMMONS COURT, FT. MYERS, FL, 33907, US
Mail Address: 12411 BRANTLEY COMMONS COURT, FT. MYERS, FL, 33907, US
ZIP code: 33907
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669660890 2007-10-12 2011-01-05 13710 METROPOLIS AVE, UNIT 104, FORT MYERS, FL, 339127144, US 13710 METROPOLIS AVE, UNIT 104, FORT MYERS, FL, 339127144, US

Contacts
Phone +1 239-332-2388
Fax 2393322382

Authorized person
Name DR. AUDREY FARAHMAND
Role MANAGER
Phone 2393322388

Taxonomy
Taxonomy Code 208200000X - Plastic Surgery Physician
License Number ME89962
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2023 202539348 2024-05-14 FARAHMAND PLASTIC SURGERY, P.L. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2022 202539348 2023-06-29 FARAHMAND PLASTIC SURGERY, P.L. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2021 202539348 2022-07-15 FARAHMAND PLASTIC SURGERY, P.L. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2020 202539348 2021-07-13 FARAHMAND PLASTIC SURGERY, P.L. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2019 202539348 2020-05-21 FARAHMAND PLASTIC SURGERY, P.L. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2018 202539348 2019-04-19 FARAHMAND PLASTIC SURGERY, P.L. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2017 202539348 2018-06-14 FARAHMAND PLASTIC SURGERY, P.L. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2016 202539348 2017-07-13 FARAHMAND PLASTIC SURGERY, P.L. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2017-07-13
Name of individual signing AUDREY FARAHMAND, M.D.
Valid signature Filed with authorized/valid electronic signature
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2015 202539348 2016-07-29 FARAHMAND PLASTIC SURGERY, P.L. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing AUDREY FARAHMAND, M.D.
Valid signature Filed with authorized/valid electronic signature
FARAHMAND PLASTIC SURGERY, P.L. 401(K) PROFIT SHARING PLAN & TRUST 2014 202539348 2015-07-06 FARAHMAND PLASTIC SURGERY, P.L. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2393322388
Plan sponsor’s address 12411 BRANTLEY COMMONS COURT, FORT MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2015-07-06
Name of individual signing AUDREY FARAHMAND, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FARAHMAND AUDREY Agent 11600 COURT OF PALMS, UNIT 605, FT. MYERS, FL, 33908

Managing Member

Name Role Address
FARAHMAND AUDREY Managing Member 11600 COURT OF PALMS, UNIT 605, FT. MYERS, FL, 33908

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2013-06-06 12411 BRANTLEY COMMONS COURT, FT. MYERS, FL 33907 No data
CHANGE OF MAILING ADDRESS 2013-06-06 12411 BRANTLEY COMMONS COURT, FT. MYERS, FL 33907 No data

Documents

Name Date
ANNUAL REPORT 2024-02-02
ANNUAL REPORT 2023-01-30
ANNUAL REPORT 2022-02-09
ANNUAL REPORT 2021-02-08
ANNUAL REPORT 2020-01-19
ANNUAL REPORT 2019-04-25
ANNUAL REPORT 2018-01-11
ANNUAL REPORT 2017-01-11
ANNUAL REPORT 2016-03-08
ANNUAL REPORT 2015-01-07

Related by officers

No related officers

Related by address

12411 BRANTLEY COMMONS COURT, FT. MYERS, FL, 33907, US

BRANTLEY MEDICAL, LLC

12411 BRANTLEY COMMONS COURT, FT. MYERS, FL, 33907, US

BRANTLEY MEDICAL, LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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