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  5. DAVID KURTZ MD PA

DAVID KURTZ MD PA

Company Details

Entity Name: DAVID KURTZ MD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 30 Jan 2004 (21 years ago)
Date of dissolution: 23 Sep 2022 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (2 years ago)
Document Number: P04000023564
FEI/EIN Number 200706342
Address: 1411 N FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
Mail Address: 1411 N FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
ZIP code: 33401
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1770610206 2007-02-28 2014-01-14 1411 N FLAGLER DR, SUITE 9400, WEST PALM BEACH, FL, 334013422, US 1411 N FLAGLER DR, SUITE 9400, WEST PALM BEACH, FL, 334013422, US

Contacts
Phone +1 561-659-7702
Fax 5616597821

Authorized person
Name DAVID KURTZ
Role PRESIDENT
Phone 5616597702

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME58226
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 064476500
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVID KURTZ DEFINED BENEFIT PLAN 2020 200706342 2021-03-17 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1309 N FLAGLER DRIVE, SUITE 1027, WEST PALM BEACH, FL, 33401
DAVID KURTZ 401(K) PLAN 2020 200706342 2021-03-17 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1309 N FLAGLER DRIVE, SUITE 1027, WEST PALM BEACH, FL, 33401
DAVID KURTZ 401(K) PLAN 2019 200706342 2020-08-26 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1309 N FLAGLER DRIVE, SUITE 1027, WEST PALM BEACH, FL, 33401
DAVID KURTZ DEFINED BENEFIT PLAN 2019 200706342 2020-08-27 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1309 N FLAGLER DRIVE, SUITE 1027, WEST PALM BEACH, FL, 33401
DAVID KURTZ DEFINED BENEFIT PLAN 2018 200706342 2019-10-02 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1411 N. FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
DAVID KURTZ 401(K) PLAN 2018 200706342 2019-08-19 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1411 N. FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
DAVID KURTZ 401(K) PLAN 2017 200706342 2018-08-06 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1411 N. FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
DAVID KURTZ DEFINED BENEFIT PLAN 2017 200706342 2018-09-04 DAVID KURTZ MD PA 2
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1411 N. FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
DAVID KURTZ DEFINED BENEFIT PLAN 2017 200706342 2019-10-01 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1411 N. FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401
DAVID KURTZ DEFINED BENEFIT PLAN 2016 200706342 2017-11-28 DAVID KURTZ MD PA 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 5616597702
Plan sponsor’s address 1411 N. FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL, 33401

Agent

Name Role Address
KURTZ DAVID I Agent 1411 N FLAGLER DRIVE, WEST PALM BEACH, FL, 33401

Director

Name Role Address
KURTZ DAVID I Director 1411 N FLAGLER DRIVE, WEST PALM BEACH, FL, 33401

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
REINSTATEMENT 2010-08-30 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2006-09-15 No data No data
REGISTERED AGENT ADDRESS CHANGED 2005-04-25 1411 N FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL 33401 No data
CHANGE OF PRINCIPAL ADDRESS 2005-04-25 1411 N FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL 33401 No data
CHANGE OF MAILING ADDRESS 2005-04-25 1411 N FLAGLER DRIVE, SUITE 9400, WEST PALM BEACH, FL 33401 No data
REGISTERED AGENT NAME CHANGED 2005-04-25 KURTZ, DAVID I No data

Documents

Name Date
ANNUAL REPORT 2021-04-29
ANNUAL REPORT 2020-06-27
ANNUAL REPORT 2019-04-30
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-04-26
ANNUAL REPORT 2016-04-27
ANNUAL REPORT 2015-04-25
ANNUAL REPORT 2014-04-25
ANNUAL REPORT 2013-04-30
ANNUAL REPORT 2012-04-27

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5416167907 2020-06-15 0455 PPP 1411 N FLAGLER DR, WEST PALM BEACH, FL, 33401-3400
Loan Status Date 2020-11-17
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 24495
Loan Approval Amount (current) 24495
Undisbursed Amount 0
Franchise Name -
Lender Location ID 124448
Servicing Lender Name Flagler Bank
Servicing Lender Address 1801 Forest Hill Blvd, WEST PALM BEACH, FL, 33406-6021
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address WEST PALM BEACH, PALM BEACH, FL, 33401-3400
Project Congressional District FL-22
Number of Employees 2
NAICS code 622110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 124448
Originating Lender Name Flagler Bank
Originating Lender Address WEST PALM BEACH, FL
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 24579.56
Forgiveness Paid Date 2020-10-22

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Date of last update: 01 Feb 2025

Sources: Florida Department of State

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