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  5. SOUTHERN MEDICAL GROUP, P.A.

SOUTHERN MEDICAL GROUP, P.A.

Company Details

Entity Name: SOUTHERN MEDICAL GROUP, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 02 Feb 1988 (37 years ago)
Last Event: AMENDMENT
Event Date Filed: 15 Aug 2017 (7 years ago)
Document Number: M66745
FEI/EIN Number 59-2871336
Address: % PAM POST, 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308
Mail Address: % PAM POST, 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308
ZIP code: 32308
County: Leon
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2023 592871336 2024-09-20 SOUTHERN MEDICAL GROUP, P.A. 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502160100
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2024-09-20
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2022 592871336 2024-10-02 SOUTHERN MEDICAL GROUP, P.A. 100
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2024-10-02
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-02
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2022 592871336 2023-09-07 SOUTHERN MEDICAL GROUP, P.A. 5
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2023-09-07
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-07
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2021 592871336 2022-12-04 SOUTHERN MEDICAL GROUP, P.A. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2022-12-04
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-12-04
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2020 592871336 2021-05-25 SOUTHERN MEDICAL GROUP, P.A. 100
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2021-05-25
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2019 592871336 2020-07-09 SOUTHERN MEDICAL GROUP, P.A. 103
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2020-07-09
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-09
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2018 592871336 2019-10-04 SOUTHERN MEDICAL GROUP, P.A. 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2019-10-04
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-04
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2017 592871336 2018-08-30 SOUTHERN MEDICAL GROUP, P.A. 89
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2018-08-30
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-30
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P. A. PROFIT SHARING PLAN 2016 592871336 2017-10-10 SOUTHERN MEDICAL GROUP, P.A. 87
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2017-10-10
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-10
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
THE SOUTHERN MEDICAL GROUP, P.A. PROFIT SHARING PLAN 2015 592871336 2016-10-07 SOUTHERN MEDICAL GROUP, P.A. 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1988-07-01
Business code 621111
Sponsor’s telephone number 8502014841
Plan sponsor’s address 1300 MEDICAL DRIVE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2016-10-07
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-07
Name of individual signing MICHAEL FORSTHOEFEL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FORSTHOEFEL, MD, MICHAEL W Agent 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308

Director

Name Role Address
ROWLAND, MD, ROBERT D Director 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308
FORSTHOEFEL, MD, MICHAEL W Director 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308
NOEL, THOMAS N Director 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308
Bouchard, Eric Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308
Allee, J. Galt Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308
Gredler, Frank Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308
Katopodis, John Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308
Khairallah, Farhat Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308
Lewis, Judith Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308
Popa, Ileana Director % PAM POST, 1300 MEDICAL DRIVE TALLAHASSEE, FL 32308

Treasurer

Name Role Address
Blake, Camille Treasurer 1300 Medical Drive, Tallahassee, FL 32308

President

Name Role Address
Edwards, Marlisha President 1300 Medical Drive, Tallahassee, FL 32308

Secretary

Name Role Address
Bavikati, Venkata Secretary 1300 Medical Drive, Tallahassee, FL 32308

Vice President

Name Role Address
Hartlage, Gregory Vice President 1300 Medical Dive, Tallahassee, FL 32308

Events

Event Type Filed Date Value Description
AMENDMENT 2017-08-15 No data No data
AMENDMENT 2016-01-11 No data No data
CHANGE OF PRINCIPAL ADDRESS 2012-04-11 % PAM POST, 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308 No data
CHANGE OF MAILING ADDRESS 2012-04-11 % PAM POST, 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308 No data
REGISTERED AGENT ADDRESS CHANGED 2006-04-12 1300 MEDICAL DRIVE, TALLAHASSEE, FL 32308 No data
AMENDMENT 2004-02-04 No data No data
REGISTERED AGENT NAME CHANGED 2002-02-06 FORSTHOEFEL, MD, MICHAEL W No data
NAME CHANGE AMENDMENT 1988-06-28 SOUTHERN MEDICAL GROUP, P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-02-14
ANNUAL REPORT 2022-08-04
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-02-06
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-03-30
Amendment 2017-08-15
ANNUAL REPORT 2017-05-28
ANNUAL REPORT 2016-05-02

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Related by address

No related companies by address

Date of last update: 04 Feb 2025

Sources: Florida Department of State

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