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  5. JOSEPH A. BOULAY, JR., M.D., P.A.

JOSEPH A. BOULAY, JR., M.D., P.A.

Company Details

Entity Name: JOSEPH A. BOULAY, JR., M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 17 Jul 2000 (25 years ago)
Date of dissolution: 25 Apr 2017 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 25 Apr 2017 (8 years ago)
Document Number: P00000067863
FEI/EIN Number 593658342
Address: 6198 52nd Street S, ST PETERSBURG, FL, 33715, US
Mail Address: 6198 52nd Street S, ST PETERSBURG, FL, 33715, US
ZIP code: 33715
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOSEPH A. BOULAY, JR., M.D., P.A. 401K PLAN 2013 593658342 2014-05-01 JOSEPH A. BOULAY, JR., M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7278251664
Plan sponsor’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705

Signature of
Role Plan administrator
Date 2014-05-01
Name of individual signing JOSEPH A. BOULAY, M.D.
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. BOULAY, JR., M.D., P.A. 401K PLAN 2012 593658342 2013-08-25 JOSEPH A. BOULAY, JR., M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7278251664
Plan sponsor’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705

Signature of
Role Plan administrator
Date 2013-08-25
Name of individual signing JOSEPH A. BOULAY, M.D.
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. BOULAY, JR., M.D., P.A. 401K PLAN 2011 593658342 2012-04-02 JOSEPH A. BOULAY, JR., M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7278251664
Plan sponsor’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705

Plan administrator’s name and address
Administrator’s EIN 593658342
Plan administrator’s name JOSEPH A. BOULAY, JR., M.D., P.A.
Plan administrator’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705
Administrator’s telephone number 7278251664

Signature of
Role Plan administrator
Date 2012-04-02
Name of individual signing JOSEPH A. BOULAY, M.D.
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. BOULAY, JR., M.D., P.A. 401K PLAN 2010 593658342 2011-02-10 JOSEPH A. BOULAY, JR., M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7278251664
Plan sponsor’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705

Plan administrator’s name and address
Administrator’s EIN 593658342
Plan administrator’s name JOSEPH A. BOULAY, JR., M.D., P.A.
Plan administrator’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705
Administrator’s telephone number 7278251664

Signature of
Role Plan administrator
Date 2011-02-10
Name of individual signing JOSEPH A. BOULAY, M.D.
Valid signature Filed with authorized/valid electronic signature
JOSEPH A. BOULAY, JR., M.D., P.A. 401K PLAN 2009 593658342 2010-05-05 JOSEPH A. BOULAY, JR., M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7278251664
Plan sponsor’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705

Plan administrator’s name and address
Administrator’s EIN 593658342
Plan administrator’s name JOSEPH A. BOULAY, JR., M.D., P.A.
Plan administrator’s address 1201 5TH AVE NORTH, STE 306, ST. PETERSBURG, FL, 33705
Administrator’s telephone number 7278251664

Signature of
Role Plan administrator
Date 2010-05-05
Name of individual signing JOSEPH A. BOULAY, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BOULAY JOSEPH A Agent 6198 52nd Street S, ST PETERSBURG, FL, 33715

Director

Name Role Address
BOULAY JOSEPH A Director 6198 52nd Street S, ST PETERSBURG, FL, 33715

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2017-04-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2016-04-11 6198 52nd Street S, ST PETERSBURG, FL 33715 No data
CHANGE OF MAILING ADDRESS 2016-04-11 6198 52nd Street S, ST PETERSBURG, FL 33715 No data
REGISTERED AGENT ADDRESS CHANGED 2016-04-11 6198 52nd Street S, ST PETERSBURG, FL 33715 No data
REGISTERED AGENT NAME CHANGED 2000-09-05 BOULAY, JOSEPH AJR. No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2017-04-25
ANNUAL REPORT 2016-04-11
ANNUAL REPORT 2015-05-16
ANNUAL REPORT 2014-04-22
ANNUAL REPORT 2013-02-13
ANNUAL REPORT 2012-02-14
ANNUAL REPORT 2011-01-07
ANNUAL REPORT 2010-01-14
ANNUAL REPORT 2009-02-12
ANNUAL REPORT 2008-03-03

Related by officers

BOULAY JOSEPH A

ST. PETERSBURG PHYSICIANS GROUP, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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