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  5. FRANK R. COLLIER, JR. M.D., P.A.

FRANK R. COLLIER, JR. M.D., P.A.

Company Details

Entity Name: FRANK R. COLLIER, JR. M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 17 Feb 2003 (22 years ago)
Date of dissolution: 17 Dec 2024 (a month ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 17 Dec 2024 (a month ago)
Document Number: P03000018680
FEI/EIN Number 65-1174019
Address: 830 A1A North, Suite 13-361, Ponte Vedra Beach, FL 32082
Mail Address: 830 A1A North, Suite 13-361, Ponte Vedra Beach, FL 32082
ZIP code: 32082
County: St. Johns
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912193491 2007-09-19 2011-03-28 6859 BELFORT OAKS PL, JACKSONVILLE, FL, 322166242, US 6859 BELFORT OAKS PL, JACKSONVILLE, FL, 322166242, US

Contacts
Phone +1 904-296-2229
Fax 9042963082

Authorized person
Name FRANK R COLLIER JR.
Role PRESIDENT
Phone 9042962229

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number 69991
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICARE DME PTAN
Number 6489910001
State FL
Issuer RAILROAD MEDICARE
Number DB9960
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2018 651174019 2019-07-16 FRANK R. COLLIER, JR. M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2017 651174019 2018-09-16 FRANK R. COLLIER, JR. M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2016 651174019 2017-09-06 FRANK R. COLLIER, JR. M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2015 651174019 2016-07-29 FRANK R. COLLIER, JR. M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2014 651174019 2015-06-30 FRANK R. COLLIER, JR. M.D., P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLANS 2013 651174019 2014-05-28 FRANK R. COLLIER, JR. M.D., P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLANS 2012 651174019 2013-08-13 FRANK R. COLLIER, JR. M.D., P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216

Signature of
Role Plan administrator
Date 2013-08-13
Name of individual signing FRANK COLLIER, JR.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-08-13
Name of individual signing FRANK COLLIER, JR.
Valid signature Filed with authorized/valid electronic signature
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2011 651174019 2012-07-03 FRANK R. COLLIER, JR. M.D., P.A. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216

Plan administrator’s name and address
Administrator’s EIN 651174019
Plan administrator’s name FRANK R. COLLIER, JR. M.D., P.A.
Plan administrator’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
Administrator’s telephone number 9042962229

Signature of
Role Plan administrator
Date 2012-07-03
Name of individual signing FRANK COLLIER JR
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-03
Name of individual signing FRANK COLLIER JR
Valid signature Filed with authorized/valid electronic signature
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2010 651174019 2011-07-26 FRANK R. COLLIER, JR. M.D., P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216

Plan administrator’s name and address
Administrator’s EIN 651174019
Plan administrator’s name FRANK R. COLLIER, JR. M.D., P.A.
Plan administrator’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
Administrator’s telephone number 9042962229

Signature of
Role Plan administrator
Date 2011-07-26
Name of individual signing FRANK R. COLLIER, JR., M. D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-26
Name of individual signing FRANK R. COLLIER, JR., M. D.
Valid signature Filed with authorized/valid electronic signature
FRANK R. COLLIER, JR. M.D., P.A. RETIREMENT SAVINGS PLAN 2009 651174019 2010-07-30 FRANK R. COLLIER, JR. M.D., P.A. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 9042962229
Plan sponsor’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216

Plan administrator’s name and address
Administrator’s EIN 651174019
Plan administrator’s name FRANK R. COLLIER, JR. M.D., P.A.
Plan administrator’s address 6859 BELFORT OAKS PLACE, JACKSONVILLE, FL, 32216
Administrator’s telephone number 9042962229

Signature of
Role Plan administrator
Date 2010-07-29
Name of individual signing FRANK R. COLLIER, JR.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-29
Name of individual signing FRANK R. COLLIER, JR.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Farah Law Agent 6550 St. Augustine Road, Suite 103, JACKSONVILLE, FL 32217

President

Name Role Address
COLLIER, M.D., FRANK R., Jr. President 830 A1A North, Suite 13-361 Ponte Vedra Beach, FL 32082

Treasurer

Name Role Address
Collier, Krystyn Treasurer 830 A1A North, Suite 13-361 Ponte Vedra Beach, FL 32082

Secretary

Name Role Address
Collier, Krystyn Secretary 830 A1A North, Suite 13-361 Ponte Vedra Beach, FL 32082

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2024-12-17 No data No data
CHANGE OF PRINCIPAL ADDRESS 2022-02-25 830 A1A North, Suite 13-361, Ponte Vedra Beach, FL 32082 No data
CHANGE OF MAILING ADDRESS 2022-02-25 830 A1A North, Suite 13-361, Ponte Vedra Beach, FL 32082 No data
REGISTERED AGENT NAME CHANGED 2020-03-17 Farah Law No data
REGISTERED AGENT ADDRESS CHANGED 2014-02-03 6550 St. Augustine Road, Suite 103, JACKSONVILLE, FL 32217 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2024-12-17
ANNUAL REPORT 2024-03-08
ANNUAL REPORT 2023-03-17
ANNUAL REPORT 2022-02-25
ANNUAL REPORT 2021-03-13
ANNUAL REPORT 2020-03-17
ANNUAL REPORT 2019-02-14
ANNUAL REPORT 2018-01-31
ANNUAL REPORT 2017-03-02
ANNUAL REPORT 2016-03-05

Related by officers

Farah Law

SNIPS LAWN & TREE SERVICE, INC. ELIAS FAMILY PARTNERS, LLC COLLIER INVESTMENTS II, LLC PANTHEON REALTY GROUP, INC. HEALTH POINTE JACKSONVILLE, LLC NEUROSPINE FLORIDA, PA ATI2, INC ADMIRALS INSURANCE CORP COLLIER MEDIA, LLC ACCELERATED DELIVERY, LLC

Related by address

830 A1A North, Suite 13-361, Ponte Vedra Beach, FL 32082

COLLIER MEDIA, LLC KRYSTYN COLLIER LLC POWERS BY EASTON 01, LLC COLLIER INVESTMENTS III, LLC OCEAN SWIM BY EASTON, LLC COLLIER HOLDINGS OF FLORIDA, LLC COLLIER INVESTMENTS IV, LLC COLLIER INVESTMENTS V, LLC FRANK R. COLLIER, JR. LLC

830 A1A North, Suite 13-361, Ponte Vedra Beach, FL 32082

COLLIER MEDIA, LLC KRYSTYN COLLIER LLC POWERS BY EASTON 01, LLC COLLIER INVESTMENTS III, LLC OCEAN SWIM BY EASTON, LLC COLLIER HOLDINGS OF FLORIDA, LLC COLLIER INVESTMENTS IV, LLC COLLIER INVESTMENTS V, LLC FRANK R. COLLIER, JR. LLC

Date of last update: 06 Jan 2025

Sources: Florida Department of State

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