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  5. BROWN FERTILITY ASSOCIATES, P.A.

BROWN FERTILITY ASSOCIATES, P.A.

Company Details

Entity Name: BROWN FERTILITY ASSOCIATES, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 17 Apr 2007 (18 years ago)
Last Event: AMENDMENT AND NAME CHANGE
Event Date Filed: 30 Oct 2008 (16 years ago)
Document Number: P07000046678
FEI/EIN Number 208832347
Address: 8149 Point Meadows Way, Jacksonville, FL, 32256, US
Mail Address: 8149 Point Meadows Way, Jacksonville, FL, 32256, US
ZIP code: 32256
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326519166 2018-12-05 2019-03-21 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 322569111, US 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 322569111, US

Contacts
Phone +1 904-260-0352

Authorized person
Name SAMUEL E BROWN
Role PRESIDENT
Phone 9042600352

Taxonomy
Taxonomy Code 207VE0102X - Reproductive Endocrinology Physician
Is Primary Yes
Taxonomy Code 363LW0102X - Women's Health Nurse Practitioner
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BROWN FERTILITY ASSOCIATES P.A. 401(K) PLAN 2023 208832347 2024-07-23 BROWN FERTILITY ASSOCIATES P.A. 55
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9043091254
Plan sponsor’s address 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 32256

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-07-23
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES P.A. 401(K) PLAN 2022 208832347 2023-07-20 BROWN FERTILITY ASSOCIATES P.A. 42
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9043091254
Plan sponsor’s address 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 32256

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2023-07-20
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES P.A. 401(K) PLAN 2021 208832347 2022-08-01 BROWN FERTILITY ASSOCIATES P.A. 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9043091254
Plan sponsor’s address 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 32256

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2022-08-01
Name of individual signing TARA EVANS
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES, P.A. 401(K) PLAN 2020 208832347 2021-07-28 BROWN FERTILITY ASSOCIATES, P.A. 40
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9042600352
Plan sponsor’s address 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing JULIUS VARZONI
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES, P.A. 401(K) PLAN 2019 208832347 2020-10-07 BROWN FERTILITY ASSOCIATES, P.A. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 9042600352
Plan sponsor’s address 8149 POINT MEADOWS WAY, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2020-10-07
Name of individual signing JULIUS VARZONI
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES 401(K) PROFIT SHARING PLAN 2013 208832347 2014-08-16 BROWN FERTILITY ASSOCIATES, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 9042600352
Plan sponsor’s address 14286-19 BEACH BLVD., NO. 385, JACKSONVILLE BEACH, FL, 32250

Signature of
Role Plan administrator
Date 2014-08-16
Name of individual signing SAMUEL BROWN
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES 401(K) PROFIT SHARING PLAN 2013 208832347 2014-07-29 BROWN FERTILITY ASSOCIATES, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 9042600352
Plan sponsor’s address 14286-19 BEACH BLVD., NO. 385, JACKSONVILLE BEACH, FL, 32250

Plan administrator’s name and address
Administrator’s EIN 208832347
Plan administrator’s name BROWN FERTILITY ASSOCIATES, P.A.
Plan administrator’s address 14286-19 BEACH BLVD., NO. 385, JACKSONVILLE BEACH, FL, 32250
Administrator’s telephone number 9042600352

Signature of
Role Plan administrator
Date 2014-07-29
Name of individual signing SAMUEL BROWN
Valid signature Filed with authorized/valid electronic signature
BROWN FERTILITY ASSOCIATES 401(K) PROFIT SHARING PLAN 2012 208832347 2013-07-29 BROWN FERTILITY ASSOCIATES, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621210
Sponsor’s telephone number 9042600352
Plan sponsor’s address 14286-19 BEACH BLVD., NO. 385, JACKSONVILLE BEACH, FL, 32250

Plan administrator’s name and address
Administrator’s EIN 208832347
Plan administrator’s name BROWN FERTILITY ASSOCIATES, P.A.
Plan administrator’s address 14286-19 BEACH BLVD., NO. 385, JACKSONVILLE BEACH, FL, 32250
Administrator’s telephone number 9042600352

Signature of
Role Plan administrator
Date 2013-07-29
Name of individual signing SAMUEL BROWN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Brown Samuel E Agent 8149 Point Meadows Way, Jacksonville, FL, 32256

President

Name Role Address
Brown Samuel E President 8149 Point Meadows Way, Jacksonville, FL, 32256

Treasurer

Name Role Address
Varzoni Julius Treasurer 2872 Pescara Dr, Jacksonville, FL, 32246

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000104778 FLORIDA CRYOSPA SERVICES ACTIVE 2014-10-15 2029-12-31 No data 137 PLANTATION CIRCLE SOUTH, PONTE VEDRA BEACH, FL, 32082
G12000091381 CONCEIVING MIRACLES ACTIVE 2012-09-18 2027-12-31 No data 8149 POINT MEADOWS DRIVE, JACKSONVILLE, FL, 32256

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-01-24 8149 Point Meadows Way, Jacksonville, FL 32256 No data
REGISTERED AGENT NAME CHANGED 2024-01-24 Brown, Samuel E. No data
CHANGE OF PRINCIPAL ADDRESS 2019-01-02 8149 Point Meadows Way, Jacksonville, FL 32256 No data
REGISTERED AGENT ADDRESS CHANGED 2019-01-02 8149 Point Meadows Way, Jacksonville, FL 32256 No data
AMENDMENT AND NAME CHANGE 2008-10-30 BROWN FERTILITY ASSOCIATES, P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-01-24
ANNUAL REPORT 2023-01-24
ANNUAL REPORT 2022-02-24
ANNUAL REPORT 2021-01-17
ANNUAL REPORT 2020-01-18
ANNUAL REPORT 2019-01-02
ANNUAL REPORT 2018-04-15
ANNUAL REPORT 2017-04-08
ANNUAL REPORT 2016-04-11
ANNUAL REPORT 2015-03-29

Related by officers

Brown Samuel E

PALATKA HOLDING, LLC

Varzoni Julius

BROWN FERTILITY, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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