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RANDALL W. BROWN, D.M.D., P.A.

Company Details

Entity Name: RANDALL W. BROWN, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 15 Aug 1990 (34 years ago)
Document Number: L95753
FEI/EIN Number 593028484
Mail Address: PO Box 818, GULF BREEZE, FL, 32562, US
Address: 3134 Gulf Breeze Prkwy, GULF BREEZE, FL, 32563, US
ZIP code: 32563
County: Santa Rosa
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
RANDALL W. BROWN, D.M.D., P.A. 401(K) PLAN 2017 593028484 2018-07-10 RANDALL W. BROWN, D.M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8509342820
Plan sponsor’s address 721 PENSACOLA BEACH BLVD., UNIT 1901, GULF BREEZE, FL, 325616811

Signature of

Role Plan administrator
Date 2018-07-10
Name of individual signing RANDALL W. BROWN
Valid signature Filed with authorized/valid electronic signature
RANDALL W. BROWN, D.M.D., P.A. 401(K) PLAN 2016 593028484 2017-10-02 RANDALL W. BROWN, D.M.D., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8509342820
Plan sponsor’s address 41 FAIRPOINT DRIVE, SUITE A, GULF BREEZE, FL, 32561

Signature of

Role Plan administrator
Date 2017-10-02
Name of individual signing RANDALL W. BROWN
Valid signature Filed with authorized/valid electronic signature
RANDALL W. BROWN, D.M.D., P.A. 401(K) PLAN 2015 593028484 2016-09-19 RANDALL W. BROWN, D.M.D., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8509342820
Plan sponsor’s address 41 FAIRPOINT DRIVE, SUITE A, GULF BREEZE, FL, 32561

Signature of

Role Plan administrator
Date 2016-09-19
Name of individual signing RANDALL W. BROWN
Valid signature Filed with authorized/valid electronic signature
RANDALL W. BROWN, D.M.D., P.A. 401(K) PLAN 2014 593028484 2015-09-21 RANDALL W. BROWN, D.M.D., P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8509342820
Plan sponsor’s address 41 FAIRPOINT DRIVE, SUITE A, GULF BREEZE, FL, 32561

Signature of

Role Plan administrator
Date 2015-09-21
Name of individual signing RANDALL W. BROWN
Valid signature Filed with authorized/valid electronic signature
RANDALL W. BROWN, D.M.D., P.A. 401(K) PLAN 2013 593028484 2014-10-13 RANDALL W. BROWN, D.M.D., P.A. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621210
Sponsor’s telephone number 8509342820
Plan sponsor’s address 41 FAIRPOINT DRIVE, SUITE A, GULF BREEZE, FL, 32561

Signature of

Role Plan administrator
Date 2014-10-13
Name of individual signing RANDALL W. BROWN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BROWN, RANDALL W. Agent 2691 Manor Circle, Gulf Breeze, FL, 32563

DRP

Name Role Address
BROWN, RANDALL W. DRP PO Box 818, GULF BREEZE, FL, 32562

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000064842 GULF COAST ORAL AND MAXILLOFACIAL SURGERY EXPIRED 2013-06-26 2018-12-31 No data 41A FAIRPOINT DRIVE, GULF BREEZE, FL, 32561

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2024-02-06 No data No data

Date of last update: 02 Jan 2025

Sources: Florida Department of State