| Entity Name: | NEUROLOGY SPECIALISTS, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Jun 2004 (21 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 24 Feb 2012 (13 years ago) |
| Document Number: | P04000091109 |
| FEI/EIN Number | 201237231 |
| Address: | 9730 COMMERCE CENTER COURT, FORT MYERS, FL, 33908 |
| Mail Address: | 9730 COMMERCE CENTER COURT, FORT MYERS, FL, 33908 |
| ZIP code: | 33908 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346303930 | 2006-12-18 | 2012-09-16 | 9730 COMMERCE CENTER CT, FORT MYERS, FL, 339083615, US | 9730 COMMERCE CENTER CT, FORT MYERS, FL, 339083615, US | |||||||||||||||||||||||||||
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| Phone | +1 239-590-9190 |
| Fax | 2399890166 |
Authorized person
| Name | MARK X NORLEANS |
| Role | ADMINISTRATOR |
| Phone | 2395909190 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | ME87954 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | P00162627 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEUROLOGY SPECIALISTS, PA 401(K) P/S PLAN | 2015 | 201237231 | 2016-07-13 | NEUROLOGY SPECIALISTS, PA | 4 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2016-07-13 |
| Name of individual signing | MARK NORLEANS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-07-13 |
| Name of individual signing | MARK NORLEANS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-03-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2395909190 |
| Plan sponsor’s address | 9730 COMMERCE CENTER CT, FORT MYERS, FL, 339083615 |
Signature of
| Role | Plan administrator |
| Date | 2016-07-13 |
| Name of individual signing | MARK NORLEANS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-07-13 |
| Name of individual signing | MARK NORLEANS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-03-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2395909190 |
| Plan sponsor’s address | 9730 COMMERCE CENTER CT, FORT MYERS, FL, 339083615 |
Signature of
| Role | Plan administrator |
| Date | 2014-04-10 |
| Name of individual signing | MARK NORLEANS |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-04-10 |
| Name of individual signing | MARK NORLEANS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DUAN NAILI | Agent | 9730 COMMERCE CENTER COURT, FORT MYERS, FL, 33908 |
| Name | Role | Address |
|---|---|---|
| DUAN NAILI | President | 9730 COMMERCE CENTER COURT, FORT MYERS, FL, 33908 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000026669 | NAILI DUAN, MD, PHD, PA | ACTIVE | 2020-02-29 | 2025-12-31 | No data | 9730 COMMERCE CENTER COURT, FORT MYERS, FL, 33908 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-01-10 | DUAN, NAILI | No data |
| REINSTATEMENT | 2012-02-24 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-24 | 9730 COMMERCE CENTER COURT, FORT MYERS, FL 33908 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| NAME CHANGE AMENDMENT | 2010-09-24 | NEUROLOGY SPECIALISTS, PA | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-10 | 9730 COMMERCE CENTER COURT, FORT MYERS, FL 33908 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-10 | 9730 COMMERCE CENTER COURT, FORT MYERS, FL 33908 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-06 |
| ANNUAL REPORT | 2022-01-13 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-12 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
