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  5. PERRI ELIZABETH YOUNG, M.D., P.A.

PERRI ELIZABETH YOUNG, M.D., P.A.

Company Details

Entity Name: PERRI ELIZABETH YOUNG, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 05 Oct 2004 (20 years ago)
Last Event: CANCEL ADM DISS/REV
Event Date Filed: 26 Jan 2010 (15 years ago)
Document Number: P04000137653
FEI/EIN Number 201708731
Address: 3850 Bird Road, SUITE 201, MIAMI, FL, 33146, US
Mail Address: 3850 Bird Road, SUITE 201, MIAMI, FL, 33146, US
ZIP code: 33146
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1568569572 2006-09-20 2008-02-11 6200 SUNSET DR, SUITE 501, SOUTH MIAMI, FL, 331434828, US 6200 SUNSET DR, SUITE 501, SOUTH MIAMI, FL, 331434828, US

Contacts
Phone +1 305-663-0609
Fax 3056677459

Authorized person
Name DR. PERRI ELIZABETH YOUNG
Role PRESIDENT
Phone 3056630609

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number ME85459
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2015 201708731 2016-09-11 PERRI ELIZABETH YOUNG, M.D., P.A. 4
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 3850 BIRD ROAD, SUITE 201, MIAMI, FL, 33146

Signature of
Role Plan administrator
Date 2016-09-11
Name of individual signing PERRI ELIZABETH YOUNG, M.D.
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2015 201708731 2016-10-17 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 3850 BIRD ROAD, SUITE 201, MIAMI, FL, 33146

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing PERRI ELIZABETH YOUNG, M.D.
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2014 201708731 2015-10-09 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 3850 BIRD ROAD, SUITE 201, MIAMI, FL, 33146

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing PERRI ELIZABETH YOUNG, M.D.
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT SHARING PLAN & TRUST 2013 201708731 2014-10-07 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT S ARING PLAN & TRUST 2012 201708731 2013-10-15 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing CAMERON KELLY
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. DEFINED BENEFIT PLAN 2012 201708731 2013-09-04 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143

Signature of
Role Plan administrator
Date 2013-09-04
Name of individual signing REBECCA TORRES
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST 2011 201708731 2012-10-09 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 201708731
Plan administrator’s name PERRI ELIZABETH YOUNG, M.D., P.A.
Plan administrator’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143
Administrator’s telephone number 3056677878

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing JANESIS DIAZ
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT S ARING PLAN & TRUST 2011 201708731 2012-10-09 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 201708731
Plan administrator’s name PERRI ELIZABETH YOUNG, M.D., P.A.
Plan administrator’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143
Administrator’s telephone number 3056677878

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing JANESIS DIAZ
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST 2010 201708731 2012-10-09 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 201708731
Plan administrator’s name PERRI ELIZABETH YOUNG, M.D., P.A.
Plan administrator’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143
Administrator’s telephone number 3056677878

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing JANESIS DIAZ
Valid signature Filed with authorized/valid electronic signature
PERRI ELIZABETH YOUNG, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2010 201708731 2012-10-09 PERRI ELIZABETH YOUNG, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541990
Sponsor’s telephone number 3056677878
Plan sponsor’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143

Plan administrator’s name and address
Administrator’s EIN 201708731
Plan administrator’s name PERRI ELIZABETH YOUNG, M.D., P.A.
Plan administrator’s address 6200 SUNSET DRIVE, SUITE 501, MIAMI, FL, 33143
Administrator’s telephone number 3056677878

Signature of
Role Plan administrator
Date 2012-10-09
Name of individual signing JANESIS DIAZ
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
YOUNG PERRI E Agent 3850 Bird Road, MIAMI, FL, 33146

Director

Name Role Address
YOUNG PERRI Director 3850 Bird Road, MIAMI, FL, 33146

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2014-02-26 3850 Bird Road, SUITE 201, MIAMI, FL 33146 No data
CHANGE OF MAILING ADDRESS 2014-02-26 3850 Bird Road, SUITE 201, MIAMI, FL 33146 No data
REGISTERED AGENT ADDRESS CHANGED 2014-02-26 3850 Bird Road, SUITE 201, MIAMI, FL 33146 No data
CANCEL ADM DISS/REV 2010-01-26 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data

Documents

Name Date
ANNUAL REPORT 2024-02-12
ANNUAL REPORT 2023-02-01
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-02-03
ANNUAL REPORT 2020-01-22
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-01-20
ANNUAL REPORT 2015-01-09

Related by officers

No related officers

Related by address

3850 Bird Road, SUITE 201, MIAMI, FL, 33146, US

SEAN A. SIMON, M.D., P.A.

3850 Bird Road, SUITE 201, MIAMI, FL, 33146, US

SEAN A. SIMON, M.D., P.A.

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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