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  5. SHIM MEDICAL, LLC

SHIM MEDICAL, LLC

Company Details

Entity Name: SHIM MEDICAL, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 23 Sep 2013 (11 years ago)
Document Number: L13000134072
FEI/EIN Number 320420816
Address: 309 STATE STREET EAST, OLDSMAR, FL, 34677, US
Mail Address: 309 STATE STREET EAST, OLDSMAR, FL, 34677, US
ZIP code: 34677
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1093356545 2019-10-07 2019-10-07 12780 RACE TRACK RD STE 200, TAMPA, FL, 336261395, US 12780 RACE TRACK RD STE 200, TAMPA, FL, 336261395, US

Contacts
Phone +1 813-814-9251
Fax 8138149261

Authorized person
Name JOHN H. SHIM
Role PRESIDENT
Phone 8138149251

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SHIM MEDICAL, LLC 401(K) PLAN 2023 320420816 2024-06-10 SHIM MEDICAL, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8138149251
Plan sponsor’s address 309 STATE ST., STE. 201, OLDSMAR, FL, 34677
SHIM MEDICAL, LLC 401(K) PLAN 2022 320420816 2023-08-24 SHIM MEDICAL, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8138149251
Plan sponsor’s address 309 STATE ST, STE. 201, OLDSMAR, FL, 34677

Signature of
Role Plan administrator
Date 2023-08-24
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-08-24
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature
SHIM MEDICAL, LLC 401(K) PLAN 2021 320420816 2022-07-27 SHIM MEDICAL, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8138149251
Plan sponsor’s address 390 STATE ST, STE. 201, OLDSMAR, FL, 34677
SHIM MEDICAL, LLC 401(K) PLAN 2020 320420816 2021-05-10 SHIM MEDICAL, LLC 6
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8138149251
Plan sponsor’s address 12780 RACETRACK ROAD, SUITE 200, TAMPA, FL, 33626

Signature of
Role Plan administrator
Date 2021-05-10
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-10
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature
SHIM MEDICAL, LLC 401(K) PLAN 2020 320420816 2021-08-19 SHIM MEDICAL, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8138149251
Plan sponsor’s address 12780 RACETRACK ROAD, SUITE 200, TAMPA, FL, 33626

Signature of
Role Plan administrator
Date 2021-08-18
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature
SHIM MEDICAL, LLC 401(K) PLAN 2019 320420816 2020-07-29 SHIM MEDICAL, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 8138149251
Plan sponsor’s address 12780 RACETRACK ROAD, SUITE 200, TAMPA, FL, 33626

Signature of
Role Plan administrator
Date 2020-07-29
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-29
Name of individual signing JOHN SHIM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHIM JOHN H Agent 309 STATE STREET EAST, OLDSMAR, FL, 34677

Manager

Name Role Address
SHIM JOHN H Manager 309 STATE STREET EAST, OLDSMAR, FL, 34677

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000066444 SHIM SPINE ACTIVE 2019-06-11 2029-12-31 No data 309 STATE ST E, STE 201, OLDSMAR, FL, 34677

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2022-11-17 309 STATE STREET EAST, SUITE 201, OLDSMAR, FL 34677 No data
REGISTERED AGENT ADDRESS CHANGED 2021-01-25 309 STATE STREET EAST, SUITE 201, OLDSMAR, FL 34677 No data
CHANGE OF PRINCIPAL ADDRESS 2020-10-19 309 STATE STREET EAST, SUITE 201, OLDSMAR, FL 34677 No data

Documents

Name Date
ANNUAL REPORT 2025-01-02
ANNUAL REPORT 2024-01-03
ANNUAL REPORT 2023-01-09
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-25
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-03-05
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-18
ANNUAL REPORT 2016-03-08

Related by officers

SHIM JOHN H

SOSUNO INVESTMENTS, LLC ENTANGLE MEDIA, LLC MED MEDIA PARTNERS, LLC THE PINELLAS NEURO-ORTHO SPINE GROUP, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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