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  5. HEATHER SHAFFER, M.D., P.A.

HEATHER SHAFFER, M.D., P.A.

Company Details

Entity Name: HEATHER SHAFFER, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 29 Aug 2003 (21 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 20 Oct 2020 (4 years ago)
Document Number: P03000095513
FEI/EIN Number 75-3125573
Address: 109 W 23rd St Ste N5, PANAMA CITY, FL 32405
Mail Address: POST OFFICE BOX 1280, PANAMA CITY, FL 32402
ZIP code: 32405
County: Bay
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HEATHER SHAFFER M D P A 401(K) PROFIT SHARING PLAN & TRUST 2023 753125573 2024-07-29 HEATHER SHAFFER M D P A 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address PO BOX 1280, PANAMA CITY, FL, 324021280

Signature of
Role Plan administrator
Date 2024-07-29
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401(K) PROFIT SHARING PLAN & TRUST 2022 753125573 2023-08-01 HEATHER SHAFFER M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address PO BOX 1280, PANAMA CITY, FL, 324021280

Signature of
Role Plan administrator
Date 2023-08-01
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401(K) PROFIT SHARING PLAN & TRUST 2021 753125573 2022-07-28 HEATHER SHAFFER M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address PO BOX 1280, PANAMA CITY, FL, 324021280

Signature of
Role Plan administrator
Date 2022-07-28
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401(K) PROFIT SHARING PLAN & TRUST 2020 753125573 2021-07-19 HEATHER SHAFFER M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 2101 NORTHSIDE DR, UNIT 502, PANAMA CITY, FL, 324053687

Signature of
Role Plan administrator
Date 2021-07-19
Name of individual signing HEATHER S ZAWAHRY
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401 K PROFIT SHARING PLAN TRUST 2018 753125573 2019-06-18 HEATHER SHAFFER M D P A 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 2101 NORTHSIDE DR, UNIT 502, PANAMA CITY, FL, 324053687

Signature of
Role Plan administrator
Date 2019-06-18
Name of individual signing HEATHER ZAWAHRY
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401 K PROFIT SHARING PLAN TRUST 2017 753125573 2018-07-31 HEATHER SHAFFER M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 2101 NORTHSIDE DR UNIT 502, PANAMA CITY, FL, 324053687

Signature of
Role Plan administrator
Date 2018-07-31
Name of individual signing HEATHER ZAWAHRY
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401 K PROFIT SHARING PLAN TRUST 2016 753125573 2017-08-01 HEATHER SHAFFER M D P A 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 2101 NORTHSIDE DR UNIT 502, PANAMA CITY, FL, 324053687

Signature of
Role Plan administrator
Date 2017-08-01
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401 K PROFIT SHARING PLAN TRUST 2015 753125573 2016-07-19 HEATHER SHAFFER M D P A 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 2101 NORTHSIDE DR UNIT 502, PANAMA CITY, FL, 324053687

Signature of
Role Plan administrator
Date 2016-07-19
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401 K PROFIT SHARING PLAN TRUST 2014 753125573 2015-07-21 HEATHER SHAFFER M D P A 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 1937 HARRISON AVE, PANAMA CITY, FL, 324054543

Signature of
Role Plan administrator
Date 2015-07-21
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature
HEATHER SHAFFER M D P A 401 K PROFIT SHARING PLAN TRUST 2013 753125573 2014-06-17 HEATHER SHAFFER M D P A 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507846300
Plan sponsor’s address 1937 HARRISON AVE, PANAMA CITY, FL, 324054543

Signature of
Role Plan administrator
Date 2014-06-17
Name of individual signing HEATHER SHAFFER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ZAWAHRY, HOSAM ESQ. Agent 109 W 23rd St Ste N5, PANAMA CITY, FL 32405

President

Name Role Address
ZAWAHRY, HEATHER S President 109 W 23rd Street, Suite N5 502 PANAMA CITY, FL 32405

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-03-15 109 W 23rd St Ste N5, PANAMA CITY, FL 32405 No data
REGISTERED AGENT ADDRESS CHANGED 2022-03-15 109 W 23rd St Ste N5, PANAMA CITY, FL 32405 No data
REINSTATEMENT 2020-10-20 No data No data
REGISTERED AGENT NAME CHANGED 2020-10-20 ZAWAHRY, HOSAM ESQ. No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-03-03
ANNUAL REPORT 2022-03-15
ANNUAL REPORT 2021-03-19
REINSTATEMENT 2020-10-20
ANNUAL REPORT 2019-02-19
ANNUAL REPORT 2018-04-09
ANNUAL REPORT 2017-04-11
ANNUAL REPORT 2016-03-29
ANNUAL REPORT 2015-03-20

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Related by address

No related companies by address

Date of last update: 30 Jan 2025

Sources: Florida Department of State

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