| Entity Name: | HNMJTS2021 PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Feb 2021 (4 years ago) |
| Document Number: | L21000087585 |
| FEI/EIN Number | 861822288 |
| Address: | 1424 US-331, DEFUNIAK SPRINGS, FL, 32435, UN |
| Mail Address: | 2276 WALTERS RD, COTTONDALE, FL, 32431, UN |
| ZIP code: | 32435 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508451287 | 2021-03-04 | 2023-12-20 | 1424 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324353401, US | 1424 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324353401, US | |||||||||||||||||
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| Phone | +1 850-920-1700 |
| Fax | 8505205357 |
| Phone | +1 509-201-7008 |
Authorized person
| Name | MICHAEL JETER |
| Role | OWNER |
| Phone | 8505205357 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HNMJTS2021 PLLC 401K PLAN | 2023 | 861822288 | 2024-09-05 | HNMJTS2021 PLLC | 6 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-09-05 |
| Name of individual signing | MICHAEL JETER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-09-01 |
| Business code | 621399 |
| Sponsor’s telephone number | 3347184295 |
| Plan sponsor’s address | 1424 US HWY 331 S,, DEFUNIAK SPRINGS, FL, 32435 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-14 |
| Name of individual signing | MICHAEL JETER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| JETER MICHAEL W | Agent | 2276 WALTERS RD, COTTONDALE, FL, 32431 |
| Name | Role | Address |
|---|---|---|
| JETER MICHAEL W | Authorized Member | 1424 US-331 S, DEFUNIAK SPRINGS, FL, 32435 |
| SIMMONS LOYD T | Authorized Member | 504 N. VARNER ST., BONIFAY, FL, 32425 |
| Jeter Brandi | Authorized Member | 1424 US-331 S, DeFuniak Springs, FL, 32435 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000093211 | DEFUNIAK ALL-CARE WALKIN CLINIC | ACTIVE | 2021-07-16 | 2026-12-31 | No data | 1424 US-331, DEFUNIAK SPRINGS, FL, 32435 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-28 |
| Florida Limited Liability | 2021-02-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
