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  5. ROYAL PALM RETIREMENT, LLC

ROYAL PALM RETIREMENT, LLC

Company Details

Entity Name: ROYAL PALM RETIREMENT, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 17 Sep 2007 (17 years ago)
Date of dissolution: 25 Sep 2015 (9 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (9 years ago)
Document Number: L07000094649
FEI/EIN Number 261091385
Address: 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760
Mail Address: 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760
ZIP code: 33760
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1841533122 2013-04-04 2013-04-04 13770 58TH ST N, SUITE 312, CLEARWATER, FL, 337603759, US 2500 AARON ST, PORT CHARLOTTE, FL, 339526743, US

Contacts
Phone +1 727-726-3980
Fax 7277265345
Phone +1 941-627-6762
Fax 9416279890

Authorized person
Name MR. STEVEN PIAZZA
Role MANAGER
Phone 7277263980

Taxonomy
Taxonomy Code 310400000X - Assisted Living Facility
License Number AL3915
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 003636500
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROYAL PALM RETIREMENT, LLC 401(K PLAN 2015 261091385 2016-07-20 ROYAL PALM RETIREMENT, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 7277263980
Plan sponsor’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760

Signature of
Role Plan administrator
Date 2016-07-20
Name of individual signing TIMOTHY R BARNES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-20
Name of individual signing TIMOTHY R BARNES
Valid signature Filed with authorized/valid electronic signature
ROYAL PALM RETIREMENT, LLC 401(K PLAN 2014 261091385 2015-06-30 ROYAL PALM RETIREMENT, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 7277263980
Plan sponsor’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760

Signature of
Role Plan administrator
Date 2015-06-30
Name of individual signing TIM BARNES
Valid signature Filed with authorized/valid electronic signature
ROYAL PALM RETIREMENT, LLC 401(K PLAN 2013 261091385 2014-07-15 ROYAL PALM RETIREMENT, LLC 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 7277263980
Plan sponsor’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760

Signature of
Role Plan administrator
Date 2014-07-15
Name of individual signing TIM BARNES
Valid signature Filed with authorized/valid electronic signature
ROYAL PALM RETIREMENT, LLC 401(K PLAN 2012 261091385 2013-07-08 ROYAL PALM RETIREMENT, LLC 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 7277263980
Plan sponsor’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760

Signature of
Role Plan administrator
Date 2013-07-08
Name of individual signing TIM BARNES
Valid signature Filed with authorized/valid electronic signature
ROYAL PALM RETIREMENT, LLC 401(K PLAN 2011 261091385 2012-08-07 ROYAL PALM RETIREMENT, LLC 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 7277263310
Plan sponsor’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760

Plan administrator’s name and address
Administrator’s EIN 261091385
Plan administrator’s name ROYAL PALM RETIREMENT, LLC
Plan administrator’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760
Administrator’s telephone number 7277263310

Signature of
Role Plan administrator
Date 2012-08-07
Name of individual signing TIM BARNES
Valid signature Filed with authorized/valid electronic signature
ROYAL PALM RETIREMENT, LLC 401(K PLAN 2010 204590916 2011-07-08 ROYAL PALM RETIREMENT, LLC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 623000
Sponsor’s telephone number 7277263310
Plan sponsor’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33770

Plan administrator’s name and address
Administrator’s EIN 204590916
Plan administrator’s name ROYAL PALM RETIREMENT, LLC
Plan administrator’s address 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33770
Administrator’s telephone number 7277263310

Signature of
Role Plan administrator
Date 2011-07-08
Name of individual signing TIM BARNES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BEHRENFELD CRAIG E Agent 601 BAYSHORE BOULEVARD, STE 700, TAMPA, FL, 33606

Manager

Name Role Address
PIAZZA STEVEN A Manager 13770 - 58TH STREET NORTH, SUITE 312, CLEARWATER, FL, 33760
PIAZZA JOHN JSr. Manager PO BOX 280, LARGO, FL, 33779

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2012-03-21 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL 33760 No data
CHANGE OF MAILING ADDRESS 2012-03-21 13770 58TH STREET NORTH, SUITE 312, CLEARWATER, FL 33760 No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J12000689631 TERMINATED 1000000344850 CHARLOTTE 2012-10-15 2022-10-17 $ 320.00 STATE OF FLORIDA, DEPARTMENT OF REVENUE, CLEARWATER SERVICE CENTER, 19337 US HIGHWAY 19 N STE 200, CLEARWATER FL337643149

Documents

Name Date
ANNUAL REPORT 2014-05-01
ANNUAL REPORT 2013-04-29
ANNUAL REPORT 2012-03-21
ANNUAL REPORT 2011-03-05
ANNUAL REPORT 2010-02-17
ANNUAL REPORT 2009-04-25
ANNUAL REPORT 2008-04-30
Florida Limited Liability 2007-09-17

Related by officers

PIAZZA STEVEN A

SENIOR MANAGEMENT ADVISORS, INC. VILLAGE OF EARL PROPERTY OWNERS ASSOCIATION,INC. 13100 PLACIDA, LLC 160 BOCILLA, LLC 22332 VICK, LLC

BEHRENFELD CRAIG E

SUNRISE BUSINESS TECHNOLOGIES, INC. CBA ADVISORS, INC. MILAN GROUP TECHNOLOGIES, LLC CUTTLEFISH, INC. GREEN WARRIOR CHEMICALS, LLC DINER PROPERTIES, INC. QUORIUM.COM, INC. LGX, INC. GC LLC WORLD SAIL EXCURSIONS, INC.

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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