| Entity Name: | EISENMAN & EISENMAN, M.D., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 24 Aug 2005 (19 years ago) |
| Document Number: | L05000084230 |
| FEI/EIN Number | 04-3832603 |
| Address: | 5065 SR 7, SUITE 201, LAKE WORTH, FL 33449 |
| Mail Address: | 5065 SR 7, SUITE 201, LAKE WORTH, FL 33449 |
| ZIP code: | 33449 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225062243 | 2006-07-10 | 2013-10-04 | 5065 STATE ROAD 7, SUITE 201, LAKE WORTH, FL, 334494615, US | 5065 STATE RD 7, SUITE 201, LAKE WORTH, FL, 334494615, US | |||||||||||||||||
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| Phone | +1 561-753-7487 |
| Fax | 5617538161 |
Authorized person
| Name | MRS. KIM M RATHFELDER |
| Role | BILLING MGR |
| Phone | 5617537487 |
Taxonomy
| Taxonomy Code | 207RG0100X - Gastroenterology Physician |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EISENMAN & EISENMAN M D LLC PROFIT SHARING PLAN & TRUST | 2010 | 043832603 | 2011-12-01 | EISENMAN & EISENMAN M.D., LLC | 10 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 043832603 |
| Plan administrator’s name | EISENMAN & EISENMAN M.D., LLC |
| Plan administrator’s address | 5065 STATE ROAD 7 STE 201, LAKE WORTH, FL, 33449 |
| Administrator’s telephone number | 5617537487 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 0 |
Signature of
| Role | Plan administrator |
| Date | 2011-12-01 |
| Name of individual signing | RICHARD EISENMAN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Eisenman, Jesse H | Agent | 5065 SR 7, SUITE 201, LAKE WORTH, FL 33449 |
| Name | Role | Address |
|---|---|---|
| Eisenman, Jesse or Richard | Manager | 5065 State Road #7, Lake Worth, FL 33449 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000015612 | ADVANCED GASTRO CONSULTANTS | ACTIVE | 2018-01-29 | 2028-12-31 | No data | 5065 STATE ROAD 7; SUITE 202, LAKE WORTH, FL, 33449 |
| G08207900126 | ADVANCED SURGERY CENTER | EXPIRED | 2008-07-25 | 2013-12-31 | No data | PO BOX 213039, ROYAL PALM BEACH, FL, 33421 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-11 | 5065 SR 7, SUITE 201, LAKE WORTH, FL 33449 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-07 | 5065 SR 7, SUITE 201, LAKE WORTH, FL 33449 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-17 | Eisenman, Jesse H | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-08 | 5065 SR 7, SUITE 201, LAKE WORTH, FL 33449 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-09 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-01-04 |
| ANNUAL REPORT | 2016-02-04 |
| ANNUAL REPORT | 2015-01-07 |
Date of last update: 04 Jan 2025
Sources: Florida Department of State
