| Entity Name: | ELLIOT ELLIS PHYSICIAN SERVICES, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 02 Nov 2010 (14 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L10000114043 |
| FEI/EIN Number | 273830461 |
| Address: | 103 TERRA LINDA PLACE, PALM BEACH GARDENS, FL, 33418, US |
| Mail Address: | 103 TERRA LINDA PLACE, PALM BEACH GARDENS, FL, 33418, US |
| ZIP code: | 33418 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELLIOT ELLIS PHYSICIAN SERVICES, PLLC WELFARE BENEFIT PLAN | 2020 | 273830461 | 2023-03-13 | ELLIOT ELLIS PHYSICIAN SERVICES PLLC | 2 | |||||||||||||||||||||||||||||||||||||
|
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| Active participants | 2 |
Signature of
| Role | Plan administrator |
| Date | 2023-03-13 |
| Name of individual signing | ELLIOT ELLIS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-03-13 |
| Name of individual signing | ELLIOT ELLIS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| WILLIAM R. BLACK & ASSOCIATES, PL | Agent |
| Name | Role | Address |
|---|---|---|
| ELLIS ELLIOT | Manager | 103 TERRA LINDA PLACE, PALM BEACH GARDENS, FL, 33418 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-13 | 103 TERRA LINDA PLACE, PALM BEACH GARDENS, FL 33418 | No data |
| CHANGE OF MAILING ADDRESS | 2012-08-13 | 103 TERRA LINDA PLACE, PALM BEACH GARDENS, FL 33418 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-08-13 | 2312 WILTON DRIVE, WILTON MANORS, FL 33305 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000055923 | TERMINATED | 1000000911778 | PALM BEACH | 2021-12-30 | 2032-02-02 | $ 522.73 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-02-10 |
| ANNUAL REPORT | 2014-03-30 |
| ANNUAL REPORT | 2013-06-10 |
| ANNUAL REPORT | 2012-08-13 |
| ANNUAL REPORT | 2011-04-26 |
| Florida Limited Liability | 2010-11-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
