| Entity Name: | HOLIDAY MEDICAL ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Dec 2001 (23 years ago) |
| Document Number: | P01000119721 |
| FEI/EIN Number | 010557628 |
| Address: | 4642 DARLINGTON RD., HOLIDAY, FL, 34690 |
| Mail Address: | 4642 DARLINGTON RD., HOLIDAY, FL, 34690 |
| ZIP code: | 34690 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053306134 | 2005-09-15 | 2010-08-31 | 4642 DARLINGTON RD, HOLIDAY, FL, 346903906, US | 4642 DARLINGTON RD, HOLIDAY, FL, 346903906, US | |||||||||||||||
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| Phone | +1 727-938-2474 |
| Fax | 7279341579 |
Authorized person
| Name | DR. JEFFREY M DAVIS |
| Role | PRESIDENT |
| Phone | 7279382474 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HOLIDAY MEDICAL ASSOCIATES, P.A. PROFIT SHARING PLAN | 2010 | 010557628 | 2011-06-07 | HOLIDAY MEDICAL ASSOCIATES, P.A. | 13 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 010557628 |
| Plan administrator’s name | HOLIDAY MEDICAL ASSOCIATES, P.A. |
| Plan administrator’s address | 4642 DARLINGTON ROAD, HOLIDAY, FL, 346903906 |
| Administrator’s telephone number | 7279374892 |
Signature of
| Role | Plan administrator |
| Date | 2011-06-07 |
| Name of individual signing | JEFFREY DAVIS |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7279374892 |
| Plan sponsor’s address | 4642 DARLINGTON ROAD, HOLIDAY, FL, 346903906 |
Plan administrator’s name and address
| Administrator’s EIN | 010557628 |
| Plan administrator’s name | HOLIDAY MEDICAL ASSOCIATES, P.A. |
| Plan administrator’s address | 4642 DARLINGTON ROAD, HOLIDAY, FL, 346903906 |
| Administrator’s telephone number | 7279374892 |
Signature of
| Role | Plan administrator |
| Date | 2011-06-07 |
| Name of individual signing | JEFFREY DAVIS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7279374892 |
| Plan sponsor’s address | 4642 DARLINGTON ROAD, HOLIDAY, FL, 346903906 |
Plan administrator’s name and address
| Administrator’s EIN | 010557628 |
| Plan administrator’s name | HOLIDAY MEDICAL ASSOCIATES, P.A. |
| Plan administrator’s address | 4642 DARLINGTON ROAD, HOLIDAY, FL, 346903906 |
| Administrator’s telephone number | 7279374892 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-21 |
| Name of individual signing | JEFFREY DAVIS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| FOX GREGORY A | Agent | 2515 COUNTRYSIDE BLVD, CLEARWATER, FL, 33763 |
| Name | Role | Address |
|---|---|---|
| DAVIS JEFFREY M | Director | 4642 DARLINGTON RD., HOLIDAY, FL, 34690 |
| MILLER RICHARD A | Director | 4642 DARLINGTON RD., HOLIDAY, FL, 34690 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-01-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2015-10-21 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
