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PALM BEACH COUNTY MEDICAL SOCIETY OF FLORIDA, INCORPORATED - Florida Company Profile

Company Details

Entity Name: PALM BEACH COUNTY MEDICAL SOCIETY OF FLORIDA, INCORPORATED
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 30 Jun 1992 (33 years ago)
Document Number: N49647
FEI/EIN Number 300130804

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 3540 FOREST HILL BLVD, SUITE 101, WEST PALM BEACH, FL, 33406, US
Mail Address: 3540 FOREST HILL BLVD, SUITE 101, WEST PALM BEACH, FL, 33406, US
ZIP code: 33406
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPLOYEE BENEFIT PLAN OF PALM BEACH COUNTY MEDICAL SOCIETY OF FLORIDA, INCORPORATED 2021 300130804 2022-07-25 PALM BEACH COUNTY MEDICAL SOCIETY OF FLORIDA, INCORPORATED 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 561110
Sponsor’s telephone number 5614333940
Plan sponsor’s address 3540 FOREST HILL BLVD STE 101, WEST PALM BEACH, FL, 334065878

Signature of

Role Plan administrator
Date 2022-07-25
Name of individual signing KELLY SKIDMORE
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF PALM BEACH COUNTY MEDICAL SOCIETY OF FLORIDA, INCORPORATED 2020 300130804 2021-03-25 PALM BEACH COUNTY MEDICAL SOCIETY OF FLORIDA, INCORPORATED 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 561110
Sponsor’s telephone number 5614333940
Plan sponsor’s address 3540 FOREST HILL BLVD STE 101, WEST PALM BEACH, FL, 334065878

Signature of

Role Plan administrator
Date 2021-03-25
Name of individual signing MINDY ACKERMAN GONZALEZ
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
Skidmore Kelly Chief Executive Officer 3540 Forest Hill Blvd. Suite 101, West Palm Beach, FL, 33406
Davanzo Dawn MD President 3540 Forest Hill Boulevard, West Palm Beach, FL, 33406
Berkman Andrew MD President 3540 Forest Hill Boulevard, West Palm Beacvh, FL, 33406
Norton Vicki Vice President 3540 Forest Hill Boulevard, West Palm Beach, FL, 33406
Gottsegen Josh MD Treasurer 3540 Forest Hill Boulevard, West Palm Beach, FL, 33406
Skidmore Kelly Agent 3540 FOREST HILL BLVD., WEST PALM BEACH, FL, 33406

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000094092 PALM BEACH COUNTY MEDICAL SOCIETY EXPIRED 2015-09-14 2020-12-31 - 3540 FOREST HILL BLVD., SUITE 101, WEST PALM BEACH, FL, 33406

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-03-25 3540 FOREST HILL BLVD, SUITE 101, WEST PALM BEACH, FL 33406 -
CHANGE OF MAILING ADDRESS 2022-03-25 3540 FOREST HILL BLVD, SUITE 101, WEST PALM BEACH, FL 33406 -
REGISTERED AGENT NAME CHANGED 2020-12-11 Skidmore, Kelly -
REGISTERED AGENT ADDRESS CHANGED 1999-03-17 3540 FOREST HILL BLVD., #101, WEST PALM BEACH, FL 33406 -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J13001174771 TERMINATED 1000000512325 PALM BEACH 2013-05-29 2023-07-10 $ 1,845.58 STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105

Documents

Name Date
ANNUAL REPORT 2024-03-11
ANNUAL REPORT 2023-03-04
ANNUAL REPORT 2022-03-25
ANNUAL REPORT 2021-02-02
AMENDED ANNUAL REPORT 2020-12-11
ANNUAL REPORT 2020-03-18
ANNUAL REPORT 2019-04-19
ANNUAL REPORT 2018-03-02
ANNUAL REPORT 2017-05-09
ANNUAL REPORT 2016-02-08

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9112287308 2020-05-01 0455 PPP 3540 FOREST HILL BLVD, WEST PALM BEACH, FL, 33406
Loan Status Date 2021-03-18
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 154400
Loan Approval Amount (current) 154400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 51009
Servicing Lender Name First-Citizens Bank & Trust Company
Servicing Lender Address 100 E. Tryon Rd DAC - 90, Raleigh, NC, 27603-3581
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description New Business or 2 years or less
Project Address WEST PALM BEACH, PALM BEACH, FL, 33406-1300
Project Congressional District FL-20
Number of Employees 11
NAICS code 813920
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 51009
Originating Lender Name First-Citizens Bank & Trust Company
Originating Lender Address Raleigh, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 155362.07
Forgiveness Paid Date 2021-02-16

Date of last update: 02 Apr 2025

Sources: Florida Department of State