| Entity Name: | JACKSONVILLE OTOLARYNGOLOGY AND FACIAL PLASTIC SURGERY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Jun 2005 (20 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P05000085193 |
| FEI/EIN Number | 202995628 |
| Address: | 836 PRUDENTIAL DR., SUITE 807, JACKSONVILLE, FL, 32207, US |
| Mail Address: | 836 PRUDENTIAL DR., SUITE 807, JACKSONVILLE, FL, 32207, US |
| ZIP code: | 32207 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JACKSONVILLE OTOLARYNGOLOGY AND FACIAL PLASTIC SURGERY 401K PLAN | 2011 | 202995628 | 2012-03-23 | JACKSONVILLE OTOLARYNGOLOGY AND FACIAL PLASTIC SURGERY P.A. | 3 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 202995628 |
| Plan administrator’s name | JACKSONVILLE OTOLARYNGOLOGY AND FACIAL PLASTIC SURGERY P.A. |
| Plan administrator’s address | 836 PRUDENTIAL DRIVE SUITE 807, JACKSONVILLE, FL, 322078335 |
| Administrator’s telephone number | 9043968060 |
Signature of
| Role | Plan administrator |
| Date | 2012-03-23 |
| Name of individual signing | SCOTT SCHARER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9043968060 |
| Plan sponsor’s address | 836 PRUDENTIAL DRIVE SUITE 807, JACKSONVILLE, FL, 322078335 |
Plan administrator’s name and address
| Administrator’s EIN | 202995628 |
| Plan administrator’s name | JACKSONVILLE OTOLARYNGOLOGY AND FACIAL PLASTIC SURGERY P.A. |
| Plan administrator’s address | 836 PRUDENTIAL DRIVE SUITE 807, JACKSONVILLE, FL, 322078335 |
| Administrator’s telephone number | 9043968060 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-13 |
| Name of individual signing | SCOTT SCHARER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2008-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9043968060 |
| Plan sponsor’s address | 836 PRUDENTIAL DRIVE SUITE 807, JACKSONVILLE, FL, 32207 |
Plan administrator’s name and address
| Administrator’s EIN | 202995628 |
| Plan administrator’s name | JACKSONVILLE OTOLARYNGOLOGY AND FACIAL PLASTIC SURGERY P.A. |
| Plan administrator’s address | 836 PRUDENTIAL DRIVE SUITE 807, JACKSONVILLE, FL, 32207 |
| Administrator’s telephone number | 9043968060 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-02 |
| Name of individual signing | SCOTT SCHARER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SCHARER SCOTT M | Agent | 836 PRUDENTIAL DR., JACKSONVILLE, FL, 32207 |
| Name | Role | Address |
|---|---|---|
| SCHARER SCOTT | Director | 13466 LONG CYPRESS TRAIL, JACKSONVILLE, FL, 32223 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-02-05 | SCHARER, SCOTT MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-08-29 | 836 PRUDENTIAL DR., SUITE 807, JACKSONVILLE, FL 32207 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-08-26 | 836 PRUDENTIAL DR., SUITE 807, JACKSONVILLE, FL 32207 | No data |
| CHANGE OF MAILING ADDRESS | 2005-08-26 | 836 PRUDENTIAL DR., SUITE 807, JACKSONVILLE, FL 32207 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-27 |
| ANNUAL REPORT | 2010-01-13 |
| ANNUAL REPORT | 2009-02-08 |
| ANNUAL REPORT | 2008-07-14 |
| ANNUAL REPORT | 2007-02-05 |
| ANNUAL REPORT | 2006-03-13 |
| Reg. Agent Change | 2005-08-29 |
| Domestic Profit | 2005-06-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
