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  5. DAVID F. RANDOLPH, D.M.D., P.A.

DAVID F. RANDOLPH, D.M.D., P.A.

Company Details

Entity Name: DAVID F. RANDOLPH, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Dec 2002 (22 years ago)
Document Number: P02000134177
FEI/EIN Number 364515831
Address: 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025
Mail Address: 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2023 364515831 2024-05-21 DAVID F. RANDOLPH, D.M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2024-05-21
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2022 364515831 2023-04-20 DAVID F. RANDOLPH, D.M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2023-04-20
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2021 364515831 2022-06-20 DAVID F. RANDOLPH, D.M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2022-06-20
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2020 364515831 2021-05-12 DAVID F. RANDOLPH, D.M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2021-05-12
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2019 364515831 2020-04-08 DAVID F. RANDOLPH, D.M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2020-04-08
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2018 364515831 2019-04-23 DAVID F. RANDOLPH, D.M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2019-04-23
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature
DAVID F. RANDOLPH, D.M.D., P.A. PROFIT SHARING PLAN AND TRUST 2017 364515831 2018-02-27 DAVID F. RANDOLPH, D.M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621210
Sponsor’s telephone number 3867554033
Plan sponsor’s address 1779 SW BARNETT WAY, SUITE 101, LAKE CITY, FL, 32025

Signature of
Role Plan administrator
Date 2018-02-27
Name of individual signing DAVID RANDOLPH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RANDOLPH DAVID FDr. Agent 1779 SW BARNETT WAY, LAKE CITY, FL, 32025

President

Name Role Address
RANDOLPH DAVID F President 1779 SW BARNETT WAY SUITE 101, LAKE CITY, FL, 32025

Director

Name Role Address
RANDOLPH DAVID F Director 1779 SW BARNETT WAY SUITE 101, LAKE CITY, FL, 32025

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2019-02-15 RANDOLPH, DAVID F, Dr. No data

Documents

Name Date
ANNUAL REPORT 2024-04-08
ANNUAL REPORT 2023-03-27
ANNUAL REPORT 2022-03-15
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-01-30
ANNUAL REPORT 2019-02-15
ANNUAL REPORT 2018-01-22
ANNUAL REPORT 2017-02-09
ANNUAL REPORT 2016-02-08
ANNUAL REPORT 2015-01-11

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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