| Entity Name: | MSPB SEPARATE ACCOUNT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 30 Oct 2003 (21 years ago) |
| Date of dissolution: | 24 Apr 2014 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 24 Apr 2014 (11 years ago) |
| Document Number: | P03000126616 |
| FEI/EIN Number | 20-0370181 |
| Address: | 5700 LAKE WORTH ROAD, SUITE 204, LAKE WORTH, FL 33463 |
| Mail Address: | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| Name | Role | Address |
|---|---|---|
| BROWN, JOHN | Agent | 5700 LAKE WORTH ROAD, SUITE 204, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| TOME, ROBERT M.D. | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| GOLDENBERG, JAMES, M.D. | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| LEVIN, ROBERT M.D. | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| ROSENFIELD, THOMAS M.D. | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Berkman, Andrew, MD | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Boyle, Thomas, MD | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Heron, James, MD | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Lira, Carlos, MD | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Simon, Todd, DO | Director | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| ROSENFIELD, THOMAS M.D. | Treasurer | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| GOLDENBERG, JAMES, M.D. | President | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| LEVIN, ROBERT M.D. | Vice President | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| TOME, ROBERT M.D. | Vice President | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| BROWN, JOHN | Chief Executive Officer | 5700 LAKE WORTH ROAD #204, LAKE WORTH, FL 33463 |
| Name | Role | Address |
|---|---|---|
| Berkman, Andrew, MD | Secretary | 5700 LAKE WORTH RD STE 204, LAKE WORTH, FL 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-04-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-25 | BROWN, JOHN | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-05-06 | 5700 LAKE WORTH ROAD, SUITE 204, LAKE WORTH, FL 33463 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-05-06 | 5700 LAKE WORTH ROAD, SUITE 204, LAKE WORTH, FL 33463 | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2014-04-24 |
| ANNUAL REPORT | 2014-03-16 |
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-04-19 |
| ANNUAL REPORT | 2011-02-21 |
| ANNUAL REPORT | 2010-04-27 |
| ANNUAL REPORT | 2009-05-06 |
| ANNUAL REPORT | 2008-04-01 |
| ANNUAL REPORT | 2007-01-04 |
| ANNUAL REPORT | 2006-01-16 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
