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  5. MOORE MEDICAL GROUP, INC.

MOORE MEDICAL GROUP, INC.

Headquarter

Company Details

Entity Name: MOORE MEDICAL GROUP, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 25 Jul 2011 (14 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 10 Dec 2012 (12 years ago)
Document Number: P11000066977
FEI/EIN Number 204389641
Address: 801 International Pkwy, Suite 500, LAKE MARY, FL, 32746, US
Mail Address: 4300 West Lake Mary Blvd, Ste 1010-357, LAKE MARY, FL, 32746, US
ZIP code: 32746
County: Seminole
Place of Formation: FLORIDA

Links between entities

Type Company Name Company Number State
Headquarter of MOORE MEDICAL GROUP, INC., COLORADO 20141310411 COLORADO

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871117572 2020-05-29 2020-05-29 801 INTERNATIONAL PKWY STE 500, LAKE MARY, FL, 327464763, US 801 INTERNATIONAL PKWY STE 500, LAKE MARY, FL, 327464763, US

Contacts
Phone +1 407-493-3549

Authorized person
Name ERIC A MOORE
Role CEO/ CJIEF MEDICAL OFFICER
Phone 4074963549

Taxonomy
Taxonomy Code 101Y00000X - Counselor
Is Primary No
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes
Taxonomy Code 207QA0000X - Adolescent Medicine (Family Medicine) Physician
Is Primary No
Taxonomy Code 207QA0505X - Adult Medicine Physician
Is Primary No
Taxonomy Code 2084P0800X - Psychiatry Physician
Is Primary No
Taxonomy Code 2084P0804X - Child & Adolescent Psychiatry Physician
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOORE MEDICAL GROUP INC 401(K) PROFIT SHARING PLAN & TRUST 2023 204389641 2024-05-06 MOORE MEDICAL GROUP INC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621491
Sponsor’s telephone number 4077327957
Plan sponsor’s address PO BOX 953935, LAKE MARY, FL, 32746

Plan administrator’s name and address
Administrator’s EIN 471637791
Plan administrator’s name ERISA FIDUCIARY SERVICES, INC.
Plan administrator’s address 1373 VETERANS HIGHWAY, SUITE 10, HAUPPAUGE, NY, 11788
Administrator’s telephone number 6312490500

Signature of
Role Plan administrator
Date 2024-05-06
Name of individual signing ERISA FIDUCIARY SERVICES
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP INC 401(K) PROFIT SHARING PLAN & TRUST 2022 204389641 2023-04-07 MOORE MEDICAL GROUP INC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621491
Sponsor’s telephone number 4077327957
Plan sponsor’s address PO BOX 953935, LAKE MARY, FL, 32746

Plan administrator’s name and address
Administrator’s EIN 471637791
Plan administrator’s name ERISA FIDUCIARY SERVICES, INC.
Plan administrator’s address 1373 VETERANS HIGHWAY, SUITE 10, HAUPPAUGE, NY, 11788
Administrator’s telephone number 6312490500

Signature of
Role Plan administrator
Date 2023-04-07
Name of individual signing ERISA FIDUCIARY SERVICES
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP 401(K) PLAN 2020 204389641 2021-07-05 MOORE MEDICAL GROUP, INC. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621112
Sponsor’s telephone number 4077327957
Plan sponsor’s address PO BOX 953935, LAKE MARY, FL, 32795

Signature of
Role Plan administrator
Date 2021-07-05
Name of individual signing ERIC A. MOORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-24
Name of individual signing SAUNDRA SANKEY
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP 401(K) PLAN 2019 204389641 2020-07-15 MOORE MEDICAL GROUP, INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621112
Sponsor’s telephone number 4077327957
Plan sponsor’s address PO BOX 953935, LAKE MARY, FL, 32795

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing ERIC A. MOORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-01
Name of individual signing SAUNDRA SANKEY
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP 401(K) PLAN 2018 204389641 2019-06-25 MOORE MEDICAL GROUP, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621112
Sponsor’s telephone number 4077327957
Plan sponsor’s address 725 PRIMERA BLVD, SUITE 220, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2019-06-25
Name of individual signing ERIC A. MOORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-31
Name of individual signing SAUNDRA SANKEY
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP 401(K) PLAN 2017 204389641 2018-09-06 MOORE MEDICAL GROUP, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621112
Sponsor’s telephone number 4077327957
Plan sponsor’s address 725 PRIMERA BLVD, SUITE 220, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2018-09-06
Name of individual signing ERIC A. MOORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-16
Name of individual signing SAUNDRA SANKEY
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP 401(K) PLAN 2016 204389641 2017-09-21 MOORE MEDICAL GROUP, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621112
Sponsor’s telephone number 4077327957
Plan sponsor’s address 725 PRIMERA BLVD, SUITE 220, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2017-09-21
Name of individual signing ERIC A. MOORE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-03
Name of individual signing SAUNDRA SANKEY
Valid signature Filed with authorized/valid electronic signature
MOORE MEDICAL GROUP 401(K) PLAN 2015 204389641 2016-07-15 MOORE MEDICAL GROUP, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 621498
Sponsor’s telephone number 4077327957
Plan sponsor’s address 725 PRIMERA BLVD, SUITE 220, LAKE MARY, FL, 32746
MOORE MEDICAL GROUP 401(K) PLAN 2014 204389641 2015-08-20 MOORE MEDICAL GROUP, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-09-01
Business code 812990
Sponsor’s telephone number 4077327957
Plan sponsor’s address 725 PRIMERA BLVD, SUITE 220, LAKE MARY, FL, 32746

Signature of
Role Plan administrator
Date 2015-08-20
Name of individual signing ERIC MOORE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MOORE ERIC Agent 424 TIMBERWALK LANE, LAKE MARY, FL, 32746

Director

Name Role Address
MOORE ERIC Director 4300 WEST LAKE MARY BLVD,, LAKE MARY, FL, 32746

Chief Financial Officer

Name Role Address
Murray Walter VCFO Chief Financial Officer 225 Cedar Rd, Covington, GA, 30016

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000087421 CAYA HEALTH ACTIVE 2020-07-23 2025-12-31 No data 4300 WEST LAKE MARY BOULEVARD, STE. 1010-357, LAKE MARY, FL, 32746

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2019-10-16 801 International Pkwy, Suite 500, LAKE MARY, FL 32746 No data
CHANGE OF MAILING ADDRESS 2019-10-16 801 International Pkwy, Suite 500, LAKE MARY, FL 32746 No data
NAME CHANGE AMENDMENT 2012-12-10 MOORE MEDICAL GROUP, INC. No data

Documents

Name Date
ANNUAL REPORT 2024-04-29
ANNUAL REPORT 2023-01-16
ANNUAL REPORT 2022-01-28
ANNUAL REPORT 2021-02-08
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-04-11
ANNUAL REPORT 2018-04-09
ANNUAL REPORT 2017-01-24
ANNUAL REPORT 2016-04-26
ANNUAL REPORT 2015-02-23

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Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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