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EMERALD COAST RHEUMATOLOGY, LLC

Company Details

Entity Name: EMERALD COAST RHEUMATOLOGY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 21 Feb 2011 (14 years ago)
Document Number: L11000022119
FEI/EIN Number 275076786
Address: 3890 Jenks Avenue, Lynn Haven, FL, 32444, US
Mail Address: 3890 Jenks Avenue, Lynn Haven, FL, 32444, US
ZIP code: 32444
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1427346469 2011-07-12 2015-06-10 3890 JENKS AVE, LYNN HAVEN, FL, 324444701, US 3890 JENKS AVE, LYNN HAVEN, FL, 324444701, US

Contacts

Phone +1 850-215-6400
Fax 8502154440

Authorized person

Name DR. AYMEN A. KENAWY
Role CEO / MEDICAL DIRECTOR
Phone 8502156400

Taxonomy

Taxonomy Code 207RR0500X - Rheumatology Physician
License Number 104930
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMERALD COAST RHEUMATOLOGY 401K PLAN 2022 275076786 2024-02-12 EMERALD COAST RHEUMATOLOGY 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444
EMERALD COAST RHEUMATOLOGY 401K PLAN 2021 275076786 2023-02-15 EMERALD COAST RHEUMATOLOGY 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444
EMERALD COAST RHEUMATOLOGY 401(K) PROFIT SHARING PLAN & TRUST 2020 275076786 2021-07-30 EMERALD COAST RHEUMATOLOGY 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8503298772
Plan sponsor’s address 3890 JENKS AVE, LYNN HAVEN, FL, 32444

Signature of

Role Plan administrator
Date 2021-07-30
Name of individual signing AYMEN KENAWY
Valid signature Filed with authorized/valid electronic signature
EMERALD COAST RHEUMATOLOGY 401(K) PROFIT SHARING PLAN & TRUST 2019 275076786 2020-07-29 EMERALD COAST RHEUMATOLOGY 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8503298772
Plan sponsor’s address 3890 JENKS AVE, LYNN HAVEN, FL, 32444

Signature of

Role Plan administrator
Date 2020-07-29
Name of individual signing ANDRE SMITH
Valid signature Filed with authorized/valid electronic signature
EMERALD COAST RHEUMATOLOGY, LL 401 K PROFIT SHARING PLAN TRUST 2018 275076786 2019-07-26 EMERALD COAST RHEUMATOLOGY 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8503298772
Plan sponsor’s address 3890 JENKS AVE, LYNN HAVEN, FL, 32444

Signature of

Role Plan administrator
Date 2019-07-26
Name of individual signing ANDRE SMITH
Valid signature Filed with authorized/valid electronic signature
EMERALD COAST RHEUMATOLOGY CASH BALANCE PENSION PLAN 2017 275076786 2018-08-20 EMERALD COAST RHEUMATOLOGY 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444
EMERALD COAST RHEUMATOLOGY 401K PLAN 2017 275076786 2018-08-20 EMERALD COAST RHEUMATOLOGY 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444
EMERALD COAST RHEUMATOLOGY CASH BALANCE PENSION PLAN 2016 275076786 2017-10-03 EMERALD COAST RHEUMATOLOGY 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444
EMERALD COAST RHEUMATOLOGY 401K PLAN 2016 275076786 2017-10-03 EMERALD COAST RHEUMATOLOGY 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444
EMERALD COAST RHEUMATOLOGY 401K PLAN 2015 275076786 2016-10-07 EMERALD COAST RHEUMATOLOGY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-08-28
Business code 621111
Sponsor’s telephone number 8502156400
Plan sponsor’s address 3890 JENKS AVENUE, LYNN HAVEN, FL, 32444

Agent

Name Role Address
PYNE LAW GROUP, PA Agent 2309 FRANKFORD AVENUE, PANAMA CITY, FL, 32405

Manager

Name Role Address
KENAWY AYMEN Manager 3890 Jenks Avenue, Lynn Haven, FL, 32444

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2016-04-29 PYNE LAW GROUP, PA No data
REGISTERED AGENT ADDRESS CHANGED 2016-04-29 2309 FRANKFORD AVENUE, SUITE A, PANAMA CITY, FL 32405 No data
CHANGE OF PRINCIPAL ADDRESS 2014-02-25 3890 Jenks Avenue, Lynn Haven, FL 32444 No data
CHANGE OF MAILING ADDRESS 2014-02-25 3890 Jenks Avenue, Lynn Haven, FL 32444 No data

Documents

Name Date
ANNUAL REPORT 2024-04-22
ANNUAL REPORT 2023-04-19
ANNUAL REPORT 2022-04-25
ANNUAL REPORT 2021-04-30
ANNUAL REPORT 2020-06-29
ANNUAL REPORT 2019-04-26
ANNUAL REPORT 2018-04-28
ANNUAL REPORT 2017-04-28
ANNUAL REPORT 2016-04-29
ANNUAL REPORT 2015-03-14

Date of last update: 03 Jan 2025

Sources: Florida Department of State