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THE BREAST CLINIC, INC. - Florida Company Profile

Company Details

Entity Name: THE BREAST CLINIC, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

THE BREAST CLINIC, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 02 May 1988 (37 years ago)
Date of dissolution: 23 Sep 2022 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (2 years ago)
Document Number: M79682
FEI/EIN Number 592883774

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 585 Fairway Court, Fort Walton Beach, FL, 32547-1809, US
Mail Address: P.O.Box 666, Shalimar, FL, 32579, US
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1558337766 2006-02-27 2011-10-28 918 MAR WALT DR, FT WALTON BEACH, FL, 325476706, US 918 MAR WALT DR, FT WALTON BEACH, FL, 325476706, US

Contacts
Phone +1 850-863-2006

Authorized person
Name SANDRA LEE HANSON
Role MEDICAL DIRECTOR
Phone 8508632006

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes

Other Provider Identifiers
Issuer RAILROAD MEDICARE PIN
Number D08079

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE BREAST CLINIC, INC. 401(K) PLAN 2019 043734645 2020-07-01 THE BREAST CLINIC, INC. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508623127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing SANDRA HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2018 043734645 2019-06-28 THE BREAST CLINIC, INC. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508623127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547

Signature of
Role Plan administrator
Date 2019-06-28
Name of individual signing SANDRA HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2017 043734645 2018-09-27 THE BREAST CLINIC, INC. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508623127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547

Signature of
Role Plan administrator
Date 2018-09-27
Name of individual signing SANDRA HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2016 043734645 2017-06-27 THE BREAST CLINIC, INC. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508623127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547

Signature of
Role Plan administrator
Date 2017-06-27
Name of individual signing SANDRA HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2015 043734645 2016-07-19 THE BREAST CLINIC, INC. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508623127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 32547

Signature of
Role Plan administrator
Date 2016-07-18
Name of individual signing SANDRA HANSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-18
Name of individual signing SANDRA HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2014 043734645 2015-10-15 THE BREAST CLINIC, INC. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508823127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing SANDRA L. HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2013 043734645 2014-10-11 THE BREAST CLINIC, INC. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508823127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706

Signature of
Role Plan administrator
Date 2014-10-11
Name of individual signing SANDRA L. HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2012 043734645 2013-10-12 THE BREAST CLINIC, INC. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508823127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706

Signature of
Role Plan administrator
Date 2013-10-12
Name of individual signing SANDRA L. HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2011 043734645 2012-10-16 THE BREAST CLINIC, INC. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508823127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706

Plan administrator’s name and address
Administrator’s EIN 043734645
Plan administrator’s name THE BREAST CLINIC, INC.
Plan administrator’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706
Administrator’s telephone number 8508823127

Signature of
Role Plan administrator
Date 2012-10-16
Name of individual signing SANDRA L. HANSON
Valid signature Filed with authorized/valid electronic signature
THE BREAST CLINIC, INC. 401(K) PLAN 2010 043734645 2011-10-17 THE BREAST CLINIC, INC. 7
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 8508823127
Plan sponsor’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706

Plan administrator’s name and address
Administrator’s EIN 043734645
Plan administrator’s name THE BREAST CLINIC, INC.
Plan administrator’s address 918 MAR WALT DRIVE, FORT WALTON BEACH, FL, 325476706
Administrator’s telephone number 8508823127

Key Officers & Management

Name Role Address
HANSON SANDRA L Dr P.O.Box 666, Shalimar, FL, 32579
Hanson Sandra LDr. Agent 585 FAIRWAY CT NE, FORT WALTON BEACH, FL, 325471809

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -
CHANGE OF PRINCIPAL ADDRESS 2021-02-03 585 Fairway Court, Fort Walton Beach, FL 32547-1809 -
REGISTERED AGENT NAME CHANGED 2021-02-03 Hanson, Sandra LEE, Dr. -
REGISTERED AGENT ADDRESS CHANGED 2021-02-03 585 FAIRWAY CT NE, FORT WALTON BEACH, FL 32547-1809 -
CHANGE OF MAILING ADDRESS 2020-05-20 585 Fairway Court, Fort Walton Beach, FL 32547-1809 -

Documents

Name Date
ANNUAL REPORT 2021-02-03
ANNUAL REPORT 2020-05-20
ANNUAL REPORT 2019-02-10
ANNUAL REPORT 2018-01-14
ANNUAL REPORT 2017-01-15
ANNUAL REPORT 2016-04-17
ANNUAL REPORT 2015-01-08
ANNUAL REPORT 2014-01-09
ANNUAL REPORT 2013-01-16
ANNUAL REPORT 2012-01-14

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Companies related by address

No other companies in our directory share the same address as THE BREAST CLINIC, INC.

Date of last update: 01 Mar 2025

Sources: Florida Department of State

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