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  5. ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.

ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.

Company Details

Entity Name: ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 22 May 2000 (25 years ago)
Last Event: AMENDMENT
Event Date Filed: 12 Aug 2019 (5 years ago)
Document Number: P00000052287
FEI/EIN Number 651011457
Address: 14601 Hope Center Loop, FT. MYERS, FL, 33912, US
Mail Address: 14601 Hope Center Loop, FT. MYERS, FL, 33912, US
ZIP code: 33912
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1720187495 2006-09-21 2024-07-02 14601 HOPE CENTER LOOP, FORT MYERS, FL, 339124707, US 14601 HOPE CENTER LOOP, FORT MYERS, FL, 339124707, US

Contacts
Phone +1 239-334-7000
Fax 2393347070

Authorized person
Name TIFFANY FAY DRAKE
Role BILLING MANAGER
Phone 2394616356

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 267898500
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2013 651011457 2014-09-18 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 132
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2393347000
Plan sponsor’s mailing address 2531 CLEVELAND AVE, FT MYERS, FL, 33901
Plan sponsor’s address 2531 CLEVELAND AVE, FT. MYERS, FL, 33901

Number of participants as of the end of the plan year
Active participants 113
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 13
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 126
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 3

Signature of
Role Plan administrator
Date 2014-09-18
Name of individual signing JEREMY SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2012 651011457 2013-10-01 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 121
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2393347000
Plan sponsor’s mailing address 2531 CLEVELAND AVE, FT MYERS, FL, 33901
Plan sponsor’s address 2531 CLEVELAND AVE, FT. MYERS, FL, 33901

Number of participants as of the end of the plan year
Active participants 100
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 21
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 121
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 12

Signature of
Role Plan administrator
Date 2013-09-30
Name of individual signing JEREMY SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2011 651011457 2012-05-08 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 119
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2393347000
Plan sponsor’s address 2531 CLEVELAND AVE, FT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 651011457
Plan administrator’s name ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.
Plan administrator’s address 2531 CLEVELAND AVE, FT MYERS, FL, 33901
Administrator’s telephone number 2393347000

Signature of
Role Plan administrator
Date 2012-05-08
Name of individual signing JEREMY SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2010 651011457 2011-06-08 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 119
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2393347000
Plan sponsor’s address 2531 CLEVELAND AVE, FT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 651011457
Plan administrator’s name ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.
Plan administrator’s address 2531 CLEVELAND AVE, FT MYERS, FL, 33901
Administrator’s telephone number 2393347000

Signature of
Role Plan administrator
Date 2011-06-08
Name of individual signing JEREMY SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2009 651011457 2010-09-02 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 110
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2393347000
Plan sponsor’s address 2531 CLEVELAND AVE, FT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 651011457
Plan administrator’s name ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.
Plan administrator’s address 2531 CLEVELAND AVE, FT MYERS, FL, 33901
Administrator’s telephone number 2393347000

Signature of
Role Plan administrator
Date 2010-08-31
Name of individual signing JEREMY SCHWARTZ
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 401(K) PROFIT SHARING PLAN 2009 651011457 2010-07-15 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. 87
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2393347000
Plan sponsor’s mailing address 2531 CLEVELAND AVE, SUITE 1, FORT MYERS, FL, 33901
Plan sponsor’s address ORTHOPEDIC SPECIALISTS OF SW FLORID, 2531 CLEVELAND AVE, FORT MYERS, FL, 33901

Plan administrator’s name and address
Administrator’s EIN 651011457
Plan administrator’s name ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A.
Plan administrator’s address 2531 CLEVELAND AVE, SUITE 1, FORT MYERS, FL, 33901
Administrator’s telephone number 2393347000

Number of participants as of the end of the plan year
Active participants 67
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 29
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 92
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 7

Signature of
Role Plan administrator
Date 2010-07-14
Name of individual signing JEREMY SCHWARTZ
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Veatch Denice Agent 14601 Hope Center Loop, FT. MYERS, FL, 33912

Vice President

Name Role Address
FLORES ANTONIO J Vice President 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
RICHARDS PAUL J Vice President 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
REYNOLDS FLETCHER A Vice President 2531 CLEVELAND AVE., FT. MYERS, FL, 33901

Director

Name Role Address
FLORES ANTONIO J Director 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
RICHARDS PAUL J Director 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
FUCHS PAUL D Director 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
SPRINGER CHARLES P Director 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
REYNOLDS FLETCHER A Director 2531 CLEVELAND AVE., FT. MYERS, FL, 33901
Leach patrick J Director 2531 CLEVELAND AVE., FT. MYERS, FL, 33901

President

Name Role Address
FUCHS PAUL D President 2531 CLEVELAND AVE., FT. MYERS, FL, 33901

Secretary

Name Role Address
SPRINGER CHARLES P Secretary 2531 CLEVELAND AVE., FT. MYERS, FL, 33901

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G08274900341 PHYSICIAN'S RECOVERY SYSTEMS EXPIRED 2008-09-30 2013-12-31 No data 2531 CLEVELAND AVENUE, SUITE 1, FORT MYERS, FL, 33901

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2024-04-12 14601 Hope Center Loop, FT. MYERS, FL 33912 No data
CHANGE OF PRINCIPAL ADDRESS 2024-04-12 14601 Hope Center Loop, FT. MYERS, FL 33912 No data
CHANGE OF MAILING ADDRESS 2024-04-12 14601 Hope Center Loop, FT. MYERS, FL 33912 No data
REGISTERED AGENT NAME CHANGED 2024-04-12 Veatch, Denice No data
AMENDMENT 2019-08-12 No data No data
AMENDMENT 2011-10-11 No data No data
AMENDMENT 2010-04-14 No data No data
NAME CHANGE AMENDMENT 2001-02-22 ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-04-12
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-01-26
ANNUAL REPORT 2021-01-14
ANNUAL REPORT 2020-01-16
Amendment 2019-08-12
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-01-12
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-25

Related by officers

FLORES ANTONIO J

ALASKA SERIES SOUTH EAST LLC RED DRAGONFLY, LLC YELLOW DRAGONFLY, LLC BALD CYPRESS, LLC VILLA SARDINIA FLORES, LLC APOLGRADOS SERVICES CORP. PORTOFINO SPRINGS LLC ASHEVILLE TERRACES, LLC BLACKSTONE @ CANYONS LLC SECOND ASHEVILLE TERRACES LLC

RICHARDS PAUL J

RICHARDS SURGERY CENTER, LLC KANE IS ABLE - MOBILE AUTO REPAIR LLC MM & S, LLC FISHING GUYS, LLC PCM PRODUCTS, INC. OSSWF DEVELOPMENT, LLC

FUCHS PAUL D

H2O AVIATION LLC FISHING FRIENDS, LLC FUCHS SUMMERLIN, LLC B.B. PROPERTIES, LLC MC GROTTO, LLC

SPRINGER CHARLES P

CPSMD CONSULTING, LLC JSCW, LLC OSSWF DEVELOPMENT, LLC

REYNOLDS FLETCHER A

REYNOLDS FAMILY, LLC FISHING GUYS, LLC CONCIERGE ORTHOPEDIC SOLUTIONS, LLC

Veatch Denice

PARAMOUNT ASC HOLDINGS, LLC OSSWF BUILDING LLC OSSWF SURGERY BUILDING LLC FMSTCSS, LLC OSSWF TRAUMA, LLC FUCHS SUMMERLIN, LLC

Related by address

14601 Hope Center Loop, FT. MYERS, FL, 33912, US

FMSTCSS, LLC OSSWF TRAUMA, LLC TCSSSTONE, LLC FUCHS SUMMERLIN, LLC

14601 Hope Center Loop, FT. MYERS, FL, 33912, US

FMSTCSS, LLC OSSWF TRAUMA, LLC TCSSSTONE, LLC FUCHS SUMMERLIN, LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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