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  5. LARRY C. DEEB, M.D., P.A.

LARRY C. DEEB, M.D., P.A.

Company Details

Entity Name: LARRY C. DEEB, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 09 Jun 2000 (25 years ago)
Date of dissolution: 27 Sep 2019 (5 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2019 (5 years ago)
Document Number: P00000055775
FEI/EIN Number 593650588
Address: 2304 Trescott Drive, TALLAHASSEE, FL, 32308, US
Mail Address: 2304 Trescott Drive, TALLAHASSEE, FL, 32308, US
ZIP code: 32308
County: Leon
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1356490619 2007-01-09 2016-02-22 2804 REMINGTON GREEN CIR, SUITE 1, TALLAHASSEE, FL, 323081550, US 2804 REMINGTON GREEN CIR, SUITE 1, TALLAHASSEE, FL, 323081550, US

Contacts
Phone +1 850-878-0184
Fax 8502161537

Authorized person
Name LARRY C DEEB
Role PRESIDENT
Phone 8508780184

Taxonomy
Taxonomy Code 2080P0205X - Pediatric Endocrinology Physician
License Number ME0036405
State FL
Is Primary Yes

Other Provider Identifiers
Issuer FLORIDA BLUE
Number P23LJ
State FL
Issuer MEDICAID
Number 039439400
State FL
Issuer MEDICAID
Number 000241018A
State GA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2017 593650588 2018-02-22 LARRY C. DEEB, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE 1, TALLAHASSEE, FL, 32308
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2016 593650588 2017-01-27 LARRY C. DEEB, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE 1, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2017-01-27
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-01-27
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2015 593650588 2016-04-08 LARRY C. DEEB, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE 1, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2016-04-08
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-08
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2014 593650588 2015-05-26 LARRY C. DEEB, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, STE 1, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2015-05-26
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2013 593650588 2014-04-15 LARRY C. DEEB, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2014-04-14
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-04-14
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2012 593650588 2013-04-03 LARRY C. DEEB, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308

Signature of
Role Plan administrator
Date 2013-04-02
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-02
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2011 593650588 2012-07-25 LARRY C. DEEB, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 593650588
Plan administrator’s name LARRY C. DEEB, M.D., P.A.
Plan administrator’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8508780184

Signature of
Role Plan administrator
Date 2012-07-24
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2010 593650588 2011-03-29 LARRY C. DEEB, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 593650588
Plan administrator’s name LARRY C. DEEB, M.D., P.A.
Plan administrator’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8508780184

Signature of
Role Plan administrator
Date 2011-03-29
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature
LARRY C. DEEB, M.D., P.A. 401(K) PROFIT SHARING PLAN 2009 593650588 2010-06-18 LARRY C. DEEB, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-07-01
Business code 621111
Sponsor’s telephone number 8508780184
Plan sponsor’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308

Plan administrator’s name and address
Administrator’s EIN 593650588
Plan administrator’s name LARRY C. DEEB, M.D., P.A.
Plan administrator’s address 2804 REMINGTON GREEN CIRCLE, SUITE, TALLAHASSEE, FL, 32308
Administrator’s telephone number 8508780184

Signature of
Role Plan administrator
Date 2010-06-17
Name of individual signing LARRY DEEB
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DEEB LARRY CDr. Agent 2304 Trescott Drive, TALLAHASSEE, FL, 32308

President

Name Role Address
DEEB LARRY CDr. President 2304 Trescott Drive, TALLAHASSEE, FL, 32308

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 No data No data
CHANGE OF PRINCIPAL ADDRESS 2018-01-10 2304 Trescott Drive, TALLAHASSEE, FL 32308 No data
CHANGE OF MAILING ADDRESS 2018-01-10 2304 Trescott Drive, TALLAHASSEE, FL 32308 No data
REGISTERED AGENT ADDRESS CHANGED 2018-01-10 2304 Trescott Drive, TALLAHASSEE, FL 32308 No data
REGISTERED AGENT NAME CHANGED 2016-01-25 DEEB, LARRY C, Dr. No data

Documents

Name Date
ANNUAL REPORT 2018-01-10
ANNUAL REPORT 2017-01-16
ANNUAL REPORT 2016-01-25
ANNUAL REPORT 2015-01-09
ANNUAL REPORT 2014-01-29
ANNUAL REPORT 2013-01-28
ANNUAL REPORT 2012-01-16
ANNUAL REPORT 2011-02-18
ANNUAL REPORT 2010-01-08
ANNUAL REPORT 2009-02-05

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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