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MARIANA MARTINASEVIC MD. PA

Company Details

Entity Name: MARIANA MARTINASEVIC MD. PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 12 Oct 2005 (19 years ago)
Document Number: P05000139677
FEI/EIN Number 203654329
Address: 2021 E Commercial Blvd, FORT LAUDERDALE, FL, 33308, US
Mail Address: 2021 E Commercial Blvd, Suite 207, FORT LAUDERDALE, FL, 33308, US
ZIP code: 33308
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1336160514 2006-07-22 2008-03-25 6245 N FEDERAL HWY, SUITE 201, FT LAUDERDALE, FL, 333081998, US 6245 N FEDERAL HWY, SUITE 201, FT LAUDERDALE, FL, 333081998, US

Contacts

Phone +1 954-491-4455
Fax 9544914553

Authorized person

Name MRS. MARIANA MARTINASEVIC
Role CEO
Phone 9544914455

Taxonomy

Taxonomy Code 174400000X - Specialist
License Number ME87810
State FL
Is Primary Yes

Other Provider Identifiers

Issuer BLUE CROSS BLUE SHIELD
Number 37860I
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARIANA MARTINASEVIC, MD, PA 401(K) PLAN 2012 203654329 2013-01-25 MARIANA MARTINASEVIC, MD, PA 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9544914455
Plan sponsor’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308

Signature of

Role Plan administrator
Date 2013-01-25
Name of individual signing JAY NICHOLSON
Valid signature Filed with authorized/valid electronic signature
MARIANA MARTINASEVIC, MD, PA 401(K) PLAN 2011 203654329 2012-03-21 MARIANA MARTINASEVIC, MD, PA 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9544914455
Plan sponsor’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308

Plan administrator’s name and address

Administrator’s EIN 203654329
Plan administrator’s name MARIANA MARTINASEVIC, MD, PA
Plan administrator’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308
Administrator’s telephone number 9544914455

Signature of

Role Plan administrator
Date 2012-03-21
Name of individual signing JAY NICHOLSON
Valid signature Filed with authorized/valid electronic signature
MARIANA MARTINASEVIC, MD, PA 401(K) PLAN 2010 203654329 2011-02-24 MARIANA MARTINASEVIC, MD, PA 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9544914455
Plan sponsor’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308

Plan administrator’s name and address

Administrator’s EIN 203654329
Plan administrator’s name MARIANA MARTINASEVIC, MD, PA
Plan administrator’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308
Administrator’s telephone number 9544914455

Signature of

Role Plan administrator
Date 2011-02-24
Name of individual signing JAY NICHOLSON
Valid signature Filed with authorized/valid electronic signature
MARIANA MARTINASEVIC, MD, PA 401(K) PLAN 2009 203654329 2010-07-02 MARIANA MARTINASEVIC, MD, PA 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 9544914455
Plan sponsor’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308

Plan administrator’s name and address

Administrator’s EIN 203654329
Plan administrator’s name MARIANA MARTINASEVIC, MD, PA
Plan administrator’s address 2400 EAST COMMERCIAL BOULEVARD, SUITE 723, FT. LAUDERDALE, FL, 33308
Administrator’s telephone number 9544914455

Signature of

Role Plan administrator
Date 2010-07-02
Name of individual signing JAY NICHOLSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MARTINASEVIC MARIANA Agent 2021 E Commercial Blvd, FORT LAUDERDALE, FL, 33308

President

Name Role Address
MARTINASEVIC MARIANA President 2400 East Commercial Boulevard, FORT LAUDERDALE, FL, 333084001

Director

Name Role Address
MARTINASEVIC MARIANA Director 2400 East Commercial Boulevard, FORT LAUDERDALE, FL, 333084001

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-04-20 2021 E Commercial Blvd, Suite 207, FORT LAUDERDALE, FL 33308 No data
CHANGE OF MAILING ADDRESS 2023-04-20 2021 E Commercial Blvd, Suite 207, FORT LAUDERDALE, FL 33308 No data
REGISTERED AGENT ADDRESS CHANGED 2023-04-20 2021 E Commercial Blvd, Suite 207, FORT LAUDERDALE, FL 33308 No data

Documents

Name Date
ANNUAL REPORT 2024-04-03
ANNUAL REPORT 2023-04-20
ANNUAL REPORT 2022-01-31
ANNUAL REPORT 2021-03-05
ANNUAL REPORT 2020-03-30
ANNUAL REPORT 2019-02-14
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-04-27
ANNUAL REPORT 2015-04-30

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6988907708 2020-05-01 0455 PPP 2400 E COMMERCIAL BLVD STE 723, FORT LAUDERDALE, FL, 33308-4052
Loan Status Date 2021-02-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 37851
Loan Approval Amount (current) 37851
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address FORT LAUDERDALE, BROWARD, FL, 33308-4052
Project Congressional District FL-23
Number of Employees 3
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 38122.7
Forgiveness Paid Date 2021-01-25

Date of last update: 02 Feb 2025

Sources: Florida Department of State