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  5. AGS HEALTHCARE SPECIALISTS, INC.

AGS HEALTHCARE SPECIALISTS, INC.

Company Details

Entity Name: AGS HEALTHCARE SPECIALISTS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 12 May 2005 (20 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: P05000070443
FEI/EIN Number 202840582
Address: 18206 fox trace ct, lutz, FL, 33549, US
Mail Address: 300 South Hyde Park Avenue, Suite 210, Tampa, FL, 33606, US
ZIP code: 33549
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467482380 2006-07-04 2011-03-23 14902 WINDING CREEK CT, STE 105-C, TAMPA, FL, 336131640, US 14902 WINDING CREEK CT, STE 105-C, TAMPA, FL, 336131640, US

Contacts
Phone +1 813-908-5685
Fax 8139682526

Authorized person
Name VICKIE EVANS
Role CFO
Phone 8134680616

Taxonomy
Taxonomy Code 363LG0600X - Gerontology Nurse Practitioner
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2017 202840582 2018-09-14 AGS HEALTHCARE SPECIALISTS INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2018-09-14
Name of individual signing VICKIE EVANS
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2017 202840582 2018-07-19 AGS HEALTHCARE SPECIALISTS INC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2018-07-19
Name of individual signing MITTYE VICTORIA EVANS
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2016 202840582 2017-07-26 AGS HEALTHCARE SPECIALISTS INC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing VICKIE EVANS
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2015 202840582 2016-06-16 AGS HEALTHCARE SPECIALISTS INC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2016-06-16
Name of individual signing VICKIE EVANS
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2014 202840582 2015-06-17 AGS HEALTHCARE SPECIALISTS INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2015-06-17
Name of individual signing VICKIE EVANS
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2013 202840582 2014-05-15 AGS HEALTHCARE SPECIALISTS INC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2014-05-15
Name of individual signing VICKIE EVANS
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2012 202840582 2013-06-10 AGS HEALTHCARE SPECIALISTS INC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Signature of
Role Plan administrator
Date 2013-06-10
Name of individual signing AGS HEALTHCARE SPECIALISTS INC
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2011 202840582 2012-07-20 AGS HEALTHCARE SPECIALISTS INC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603

Plan administrator’s name and address
Administrator’s EIN 202840582
Plan administrator’s name AGS HEALTHCARE SPECIALISTS INC
Plan administrator’s address 18206 FOX TRACE CT, LUTZ, FL, 335499603
Administrator’s telephone number 8134680616

Signature of
Role Plan administrator
Date 2012-07-20
Name of individual signing AGS HEALTHCARE SPECIALISTS INC
Valid signature Filed with authorized/valid electronic signature
AGS HEALTHCARE SPECIALISTS INC 401 K PROFIT SHARING PLAN TRUST 2010 202840582 2011-07-01 AGS HEALTHCARE SPECIALISTS INC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-03-01
Business code 621610
Sponsor’s telephone number 8134680616
Plan sponsor’s address 18206 FOX TRACE CT, LUTZ, FL, 335490000

Plan administrator’s name and address
Administrator’s EIN 202840582
Plan administrator’s name AGS HEALTHCARE SPECIALISTS INC
Plan administrator’s address 18206 FOX TRACE CT, LUTZ, FL, 335490000
Administrator’s telephone number 8134680616

Signature of
Role Plan administrator
Date 2011-07-01
Name of individual signing AGS HEALTHCARE SPECIALISTS INC
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
EVANS VIVIENNE Agent 300 South Hyde Park Avenue, Tampa, FL, 33606

Officer

Name Role Address
Koehler Tim Officer 270 North Main Street, Stillwater, MN, 55082
EVANS VIVIENNE Officer 300 South Hyde Park Avenue, Tampa, FL, 33606

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 No data No data
CHANGE OF PRINCIPAL ADDRESS 2017-04-21 18206 fox trace ct, lutz, FL 33549 No data
REGISTERED AGENT NAME CHANGED 2017-04-21 EVANS, VIVIENNE No data
CHANGE OF MAILING ADDRESS 2016-08-18 18206 fox trace ct, lutz, FL 33549 No data
REGISTERED AGENT ADDRESS CHANGED 2016-08-18 300 South Hyde Park Avenue, Suite 210, Tampa, FL 33606 No data
NAME CHANGE AMENDMENT 2006-12-04 AGS HEALTHCARE SPECIALISTS, INC. No data
NAME CHANGE AMENDMENT 2005-06-22 VIVIENNE EVANS ARNP, INC. No data

Documents

Name Date
ANNUAL REPORT 2017-04-21
AMENDED ANNUAL REPORT 2016-08-18
ANNUAL REPORT 2016-03-03
ANNUAL REPORT 2015-01-10
ANNUAL REPORT 2014-06-10
ANNUAL REPORT 2013-04-01
ANNUAL REPORT 2012-04-06
ANNUAL REPORT 2011-03-24
ANNUAL REPORT 2010-04-16
ANNUAL REPORT 2009-04-30

Related by officers

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Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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