Entity Name: | MFE PSYCHIATRY LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Co. |
Status: | Active |
Date Filed: | 07 Jun 2018 (7 years ago) |
Last Event: | REINSTATEMENT |
Event Date Filed: | 09 Mar 2020 (5 years ago) |
Document Number: | L18000141071 |
FEI/EIN Number | 83-0888876 |
Address: | 13801 Bruce B Downs Blvd, Tampa, FL, 33613, US |
Mail Address: | 13801 Bruce B Downs Blvd, Tampa, FL, 33613, US |
ZIP code: | 33613 |
County: | Hillsborough |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1285256040 | 2020-05-14 | 2024-10-16 | 13801 BRUCE B DOWNS BLVD STE 305, TAMPA, FL, 336133939, US | 13801 BRUCE B DOWNS BLVD STE 305, TAMPA, FL, 336133939, US | |||||||||||||||||
|
Phone | +1 352-519-2119 |
Authorized person
Name | MARC ETTENSOHN |
Role | CEO FOUNDER |
Phone | 3525192119 |
Taxonomy
Taxonomy Code | 207Q00000X - Family Medicine Physician |
Is Primary | Yes |
Taxonomy Code | 2084P0800X - Psychiatry Physician |
Is Primary | No |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
MFE PSYCHIATRY LLC 401(K) PLAN | 2023 | 830888876 | 2024-05-14 | MFE PSYCHIATRY LLC | 11 | |||||||||||||||||||||||||||||||
|
Administrator’s EIN | 474474775 |
Plan administrator’s name | GUIDELINE, INC. |
Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
Administrator’s telephone number | 8882283491 |
Signature of
Role | Plan administrator |
Date | 2024-05-14 |
Name of individual signing | QIAN LIU |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2021-08-02 |
Business code | 621112 |
Sponsor’s telephone number | 3525192119 |
Plan sponsor’s address | 410 EVERNIA ST, APT 613, WEST PALM BEACH, FL, 33401 |
Plan administrator’s name and address
Administrator’s EIN | 474474775 |
Plan administrator’s name | GUIDELINE, INC. |
Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
Administrator’s telephone number | 8882283491 |
Signature of
Role | Plan administrator |
Date | 2023-05-27 |
Name of individual signing | CHRISTINE RIMER |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2021-08-02 |
Business code | 621112 |
Sponsor’s telephone number | 3525192119 |
Plan sponsor’s address | 410 EVERNIA ST, APT 613, WEST PALM BEACH, FL, 33401 |
Plan administrator’s name and address
Administrator’s EIN | 474474775 |
Plan administrator’s name | GUIDELINE, INC. |
Plan administrator’s address | 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702 |
Administrator’s telephone number | 8882283491 |
Signature of
Role | Plan administrator |
Date | 2022-06-02 |
Name of individual signing | CHRISTINE RIMER |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role | Address |
---|---|---|
Marc Ettensohn | Agent | 13801 Bruce B Downs Blvd, Tampa, FL, 33613 |
Name | Role | Address |
---|---|---|
ETTENSOHN MARC | Authorized Member | 13801 BRUCE B DOWNS BLVD, TAMPA, FL, 33613 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G21000101876 | CORNERSTONE PSYCHIATRIC CARE | ACTIVE | 2021-08-04 | 2026-12-31 | No data | 410 EVERNIA ST, STE 613, WEST PALM BEACH, FL, 33401 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
REGISTERED AGENT ADDRESS CHANGED | 2024-03-17 | 13801 Bruce B Downs Blvd, ste 305, Tampa, FL 33613 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2023-09-29 | 13801 Bruce B Downs Blvd, Tampa, FL 33613 | No data |
CHANGE OF MAILING ADDRESS | 2023-09-29 | 13801 Bruce B Downs Blvd, Tampa, FL 33613 | No data |
REINSTATEMENT | 2020-03-09 | No data | No data |
REGISTERED AGENT NAME CHANGED | 2020-03-09 | Marc Ettensohn | No data |
ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-03-17 |
ANNUAL REPORT | 2023-01-23 |
ANNUAL REPORT | 2022-01-26 |
ANNUAL REPORT | 2021-05-30 |
REINSTATEMENT | 2020-03-09 |
Florida Limited Liability | 2018-06-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State