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  5. SOUTHERN PINELLAS SURGICAL, P.A.

SOUTHERN PINELLAS SURGICAL, P.A.

Company Details

Entity Name: SOUTHERN PINELLAS SURGICAL, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 12 Jul 2004 (21 years ago)
Date of dissolution: 28 Sep 2018 (6 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 28 Sep 2018 (6 years ago)
Document Number: P04000103339
FEI/EIN Number 201354098
Address: 11200 SEMINOLE BLVD, LARGO, FL, 33778, US
Mail Address: 11200 SEMINOLE BLVD, LARGO, FL, 33778, US
ZIP code: 33778
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHERN PINELLAS SURGICAL, P.A. PENSION PLAN 2018 201354098 2019-10-15 SOUTHERN PINELLAS SURGICAL, P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778
SOUTHERN PINELLAS SURGICAL, P.A. 401(K) PLAN 2018 201354098 2019-10-15 SOUTHERN PINELLAS SURGICAL, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778
SOUTHERN PINELLAS SURGICAL, P.A. 401(K) PLAN 2017 201354098 2018-07-30 SOUTHERN PINELLAS SURGICAL, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778
SOUTHERN PINELLAS SURGICAL, P.A. PENSION PLAN 2017 201354098 2018-07-30 SOUTHERN PINELLAS SURGICAL, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778
SOUTHERN PINELLAS SURGICAL, P.A. 401(K) PLAN 2016 201354098 2018-01-29 SOUTHERN PINELLAS SURGICAL, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778

Signature of
Role Plan administrator
Date 2018-01-29
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-01-29
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
SOUTHERN PINELLAS SURGICAL, P.A. PENSION PLAN 2016 201354098 2018-01-29 SOUTHERN PINELLAS SURGICAL, P.A. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778

Signature of
Role Plan administrator
Date 2018-01-29
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-01-29
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
SOUTHERN PINELLAS SURGICAL, P.A. 401(K) PLAN 2015 201354098 2016-10-10 SOUTHERN PINELLAS SURGICAL, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778

Signature of
Role Plan administrator
Date 2016-10-08
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
SOUTHERN PINELLAS SURGICAL, P.A. PENSION PLAN 2015 201354098 2016-10-10 SOUTHERN PINELLAS SURGICAL, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778

Signature of
Role Plan administrator
Date 2016-10-08
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
SOUTHERN PINELLAS SURGICAL, P.A. PENSION PLAN 2014 201354098 2015-10-15 SOUTHERN PINELLAS SURGICAL, P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature
SOUTHERN PINELLAS SURGICAL, P.A. 401(K) PLAN 2014 201354098 2015-10-15 SOUTHERN PINELLAS SURGICAL, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 7275849500
Plan sponsor’s address 12955 SEMINOLE BOULEVARD, LARGO, FL, 33778

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing RICHARD FANSLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FANSLER RICHARD F. Agent 11200 SEMINOLE BLVD, LARGO, FL, 33778

Director

Name Role Address
FANSLER RICHARD Director 12942 Harbor View Drive, SEMINOLE, FL, 33776

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 No data No data
CHANGE OF PRINCIPAL ADDRESS 2016-03-30 11200 SEMINOLE BLVD, Suite 210, LARGO, FL 33778 No data
CHANGE OF MAILING ADDRESS 2016-03-30 11200 SEMINOLE BLVD, Suite 210, LARGO, FL 33778 No data
REGISTERED AGENT ADDRESS CHANGED 2016-03-30 11200 SEMINOLE BLVD, Suite 210, LARGO, FL 33778 No data
REGISTERED AGENT NAME CHANGED 2005-05-01 FANSLER, RICHARD F. No data
AMENDED AND RESTATEDARTICLES 2004-07-20 No data No data

Documents

Name Date
ANNUAL REPORT 2017-01-15
ANNUAL REPORT 2016-03-30
ANNUAL REPORT 2015-01-26
ANNUAL REPORT 2014-05-01
ANNUAL REPORT 2013-02-05
ANNUAL REPORT 2012-01-18
ANNUAL REPORT 2011-01-17
ANNUAL REPORT 2010-01-09
ANNUAL REPORT 2009-01-17
ANNUAL REPORT 2008-05-01

Related by officers

FANSLER RICHARD

PREMIER AESTHETICS LLC FANSLER ANTERIOR SPINAL ACCESS, P.L. FANSLER SPINAL ACCESS LLC FRS FLORIDA HOLDINGS LLC

Related by address

11200 SEMINOLE BLVD, LARGO, FL, 33778, US

VERIMED HEALTH GROUP SEMINOLE, LLC

11200 SEMINOLE BLVD, LARGO, FL, 33778, US

VERIMED HEALTH GROUP SEMINOLE, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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