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  5. PERWAIZ RAHIM, M.D., P.A.

PERWAIZ RAHIM, M.D., P.A.

Company Details

Entity Name: PERWAIZ RAHIM, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Sep 2004 (20 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 05 Jan 2023 (2 years ago)
Document Number: P04000132002
FEI/EIN Number 342017298
Address: 4712 Exploration Avenue, LAKELAND, FL, 33812, US
Mail Address: 4712 Exploration Avenue, LAKELAND, FL, 33812, US
ZIP code: 33812
County: Polk
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERWAIZ RAHIM, M.D., P. A. 401 (K) PLAN 2023 342017298 2024-10-15 PERWAIZ RAHIM, M.D., P. A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DR, LAKELAND, FL, 338124106

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT, INC.
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
PERWAIZ RAHIM, M.D., P. A. 401 (K) PLAN 2022 342017298 2023-06-30 PERWAIZ RAHIM, M.D., P. A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DR, LAKELAND, FL, 338124106

Plan administrator’s name and address
Administrator’s EIN 200200514
Plan administrator’s name RECEIVERSHIP MANAGEMENT INC
Plan administrator’s address 510 HOSPITAL DR STE 490, MADISON, TN, 371155049
Administrator’s telephone number 6153700051

Signature of
Role Plan administrator
Date 2023-06-30
Name of individual signing ROBERT MOORE
Valid signature Filed with authorized/valid electronic signature
PERWAIZ RAHIM, M. D. , P. A. 401(K) PLAN 2021 342017298 2024-11-12 PERWAIZ RAHIM, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812

Signature of
Role Plan administrator
Date 2024-11-12
Name of individual signing PERWAIZ RAHIM
Valid signature Filed with authorized/valid electronic signature
PERWAIZ RAHIM, M. D. , P. A. 401(K) PLAN 2020 342017298 2021-10-12 PERWAIZ RAHIM, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing PERWAIZ RAHIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-12
Name of individual signing PERWAIZ RAHIM
Valid signature Filed with authorized/valid electronic signature
PERWAIZ RAHIM, M. D. , P. A. 401(K) PLAN 2019 342017298 2020-10-15 PERWAIZ RAHIM, M.D., 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 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing PERWAIZ H. RAHIM M.D.
Valid signature Filed with authorized/valid electronic signature
PERWAIZ RAHIM, M. D. , P. A. 401(K) PLAN 2018 342017298 2020-10-15 PERWAIZ RAHIM, M.D., P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812
PERWAIZ RAHIM, M. D. , P. A. 401(K) PLAN 2018 342017298 2019-10-15 PERWAIZ RAHIM, M.D., P.A. 21
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812
PERWAIZ RAHIM, M.D., P.A. 401(K) PLAN 2017 342017298 2018-06-04 PERWAIZ RAHIM, M.D., P.A. 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812
PERWAIZ RAHIM, M.D., P.A. 401(K) PLAN 2016 342017298 2017-10-17 PERWAIZ RAHIM, M.D., P.A. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812
PERWAIZ RAHIM, M.D., P.A. 401(K) PLAN 2015 342017298 2016-10-04 PERWAIZ RAHIM, M.D., P.A. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8635343707
Plan sponsor’s address 3651 INNOVATION DRIVE, LAKELAND, FL, 33812

Signature of
Role Plan administrator
Date 2016-10-04
Name of individual signing PERWAIZ RAHIM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RAHIM PERWAIZ H Agent 3656 INNOVATION DRIVE, LAKELAND, FL, 33812

Manager

Name Role Address
RAHIM PERWAIZ H Manager 3656 INNOVATION DRIVE, LAKELAND, FL, 33812

Director

Name Role Address
RAHIM PERWAIZ H Director 3656 INNOVATION DRIVE, LAKELAND, FL, 33812

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-12-27 4712 Exploration Avenue, LAKELAND, FL 33812 No data
CHANGE OF PRINCIPAL ADDRESS 2024-12-27 4712 Exploration Avenue, LAKELAND, FL 33812 No data
REINSTATEMENT 2023-01-05 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
REINSTATEMENT 2021-03-08 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data
REGISTERED AGENT ADDRESS CHANGED 2018-08-06 3656 INNOVATION DRIVE, LAKELAND, FL 33812 No data
REINSTATEMENT 2016-10-21 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 No data No data
REGISTERED AGENT NAME CHANGED 2015-09-21 RAHIM, PERWAIZ H No data

Documents

Name Date
ANNUAL REPORT 2024-02-09
REINSTATEMENT 2023-01-05
REINSTATEMENT 2021-03-08
ANNUAL REPORT 2019-04-30
ANNUAL REPORT 2018-08-06
ANNUAL REPORT 2017-07-03
REINSTATEMENT 2016-10-21
REINSTATEMENT 2015-09-21
ANNUAL REPORT 2013-01-16
REINSTATEMENT 2012-11-14

Related by officers

RAHIM PERWAIZ H

CYNERGY URGENT CARE, LLC RAHIM INVESTMENT COMPANY, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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