| Entity Name: | JOHN ANTHONY WHITE, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 27 Jul 1990 (35 years ago) |
| Document Number: | L90521 |
| FEI/EIN Number | 59-3020458 |
| Address: | 1900 N Atlantic Ave Unit 1902, Unit 1902, DAYTONA BEACH, FL 32118 |
| Mail Address: | 1900 N Atlantic Ave Unit 1902, Unit 1902, DAYTONA BEACH, FL 32118 |
| ZIP code: | 32118 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497852610 | 2006-09-20 | 2009-08-21 | 533 N CLYDE MORRIS BLVD STE A, DAYTONA BEACH, FL, 321142323, US | 533 N CLYDE MORRIS BLVD STE A, DAYTONA BEACH, FL, 321142323, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 386-255-0909 |
| Fax | 3862554454 |
Authorized person
| Name | MS. HELEN M TIPLADY |
| Role | NURSE |
| Phone | 3862550901 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | ME0039128 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN ANTHONY WHITE, M.D., P.A. 401(K) PROFIT SHARING PLAN | 2011 | 593020458 | 2012-06-25 | JOHN ANTHONY WHITE, M.D., P.A. | 10 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 593020458 |
| Plan administrator’s name | JOHN ANTHONY WHITE, M.D., P.A. |
| Plan administrator’s address | 533 NORTH CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Administrator’s telephone number | 3862550901 |
Signature of
| Role | Plan administrator |
| Date | 2012-06-25 |
| Name of individual signing | ANDREA WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1986-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3862550901 |
| Plan sponsor’s address | 533 NORTH CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
Plan administrator’s name and address
| Administrator’s EIN | 593020458 |
| Plan administrator’s name | JOHN ANTHONY WHITE, M.D., P.A. |
| Plan administrator’s address | 533 NORTH CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Administrator’s telephone number | 3862550901 |
Signature of
| Role | Plan administrator |
| Date | 2011-06-22 |
| Name of individual signing | ANDREA WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1986-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3862550901 |
| Plan sponsor’s address | 533 NORTH CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
Plan administrator’s name and address
| Administrator’s EIN | 593020458 |
| Plan administrator’s name | JOHN ANTHONY WHITE, M.D., P.A. |
| Plan administrator’s address | 533 NORTH CLYDE MORRIS BLVD., DAYTONA BEACH, FL, 32114 |
| Administrator’s telephone number | 3862550901 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-12 |
| Name of individual signing | ANDREA WHITE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GORNTO AND GORNTO | Agent | 310 Wilmette Avenue, Suite 5, Ormond Beach, FL 32174 |
| Name | Role | Address |
|---|---|---|
| White, John | Chairman | 1900 N Atlantic Ave Unit 1902, Unit 1902 DAYTONA BEACH, FL 32118 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-23 | 1900 N Atlantic Ave Unit 1902, Unit 1902, DAYTONA BEACH, FL 32118 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-23 | 1900 N Atlantic Ave Unit 1902, Unit 1902, DAYTONA BEACH, FL 32118 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-23 | 310 Wilmette Avenue, Suite 5, Ormond Beach, FL 32174 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-01-17 | GORNTO AND GORNTO | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-23 |
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-01-29 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-23 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
