| Entity Name: | PLATINUM MEDICAL ADMINISTRATION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 17 Apr 2019 (6 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L19000105390 |
| FEI/EIN Number | 834538696 |
| Address: | 5318 W CRENSHAW ST, TAMPA, FL, 33634, US |
| Mail Address: | 5318 W CRENSHAW ST, TAMPA, FL, 33634, US |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PLATINUM MEDICAL ADMINISTRATION, LLC 401K | 2021 | 834538696 | 2022-07-11 | PLATINUM MEDICAL ADMINISTRATION, | 20 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2022-07-11 |
| Name of individual signing | JULIE KOCH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 8133216819 |
| Plan sponsor’s address | 5318 W CRENSHAW STREET, TAMPA, FL, 33634 |
Signature of
| Role | Plan administrator |
| Date | 2021-09-09 |
| Name of individual signing | JULIE KOCH |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 8133216819 |
| Plan sponsor’s address | 5318 W CRENSHAW STREET, TAMPA, FL, 33634 |
Signature of
| Role | Plan administrator |
| Date | 2020-07-30 |
| Name of individual signing | JULIE KOCH |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| PLATINUM WEALTH VENTURE, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| POTTER DAVID L | Authorized Member | 5318 W CRENSHAW ST, TAMPA, FL, 33634 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| LC DISSOCIATION MEM | 2021-06-07 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-24 | 5318 W CRENSHAW ST, TAMPA, FL 33634 | No data |
| LC AMENDMENT | 2019-12-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-12-23 | 5318 W CRENSHAW ST, TAMPA, FL 33634 | No data |
| CHANGE OF MAILING ADDRESS | 2019-12-23 | 5318 W CRENSHAW ST, TAMPA, FL 33634 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000312597 | ACTIVE | 1000000926552 | HILLSBOROU | 2022-06-22 | 2032-06-29 | $ 2,542.57 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 5483 W WATERS AVE STE 1210, TAMPA FL336341236 |
| J22000056921 | ACTIVE | 1000000912513 | HILLSBOROU | 2022-01-12 | 2032-02-02 | $ 4,110.64 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 5483 W WATERS AVE STE 1210, TAMPA FL336341236 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-05-02 |
| CORLCDSMEM | 2021-06-07 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-24 |
| LC Amendment | 2019-12-23 |
| Florida Limited Liability | 2019-04-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
