| Entity Name: | RODERICK M URBANIAK M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 25 Apr 2013 (12 years ago) |
| Document Number: | P13000037216 |
| FEI/EIN Number | 46-2637595 |
| Address: | 13201 Walsingham Road, Largo, FL, 33774, US |
| Mail Address: | 13201 Walsingham Road, Largo, FL, 33774, US |
| ZIP code: | 33774 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942640719 | 2013-06-26 | 2013-06-26 | 609 LAKEVIEW RD, CLEARWATER, FL, 337563335, US | 609 LAKEVIEW RD, CLEARWATER, FL, 337563335, US | |||||||||||||||||||
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| Phone | +1 727-447-4536 |
| Fax | 7274421600 |
Authorized person
| Name | MS. GINGER LYNN WIERSMA |
| Role | OFFICE MANAGER |
| Phone | 6162184495 |
Taxonomy
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| License Number | 4301083724 |
| State | MI |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RODERICK M. URBANIAK M.D., P.A. 401(K) PLAN | 2023 | 462637595 | 2024-07-23 | RODERICK M. URBANIAK M.D., P.A. | 11 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-23 |
| Name of individual signing | RODERICK URBANIAK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7274474536 |
| Plan sponsor’s address | 13201 WALSINGHAM ROAD STE 200, LARGO, FL, 33774 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-08 |
| Name of individual signing | RODERICK URBANIAK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7274474536 |
| Plan sponsor’s address | 13201 WALSINGHAM ROAD STE 200, LARGO, FL, 33774 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-03 |
| Name of individual signing | RODERICK URBANIAK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7272611754 |
| Plan sponsor’s address | 13201 WALSINGHAM ROAD, SUITE 200, LARGO, FL, 33774 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 7272611754 |
| Plan sponsor’s address | 13201 WALSINGHAM ROAD, SUITE 200, LARGO, FL, 33774 |
| Name | Role | Address |
|---|---|---|
| Hershkowitz & Kunitzer, P.A. | Agent | 5039 Central Avenue, St. Petersburg, FL, 337108240 |
| Name | Role | Address |
|---|---|---|
| URBANIAK RODERICK | President | 13201 Walsingham Road, Largo, FL, 33774 |
| Name | Role | Address |
|---|---|---|
| URBANIAK RODERICK | Vice President | 13201 Walsingham Road, Largo, FL, 33774 |
| Name | Role | Address |
|---|---|---|
| URBANIAK RODERICK | Secretary | 13201 Walsingham Road, Largo, FL, 33774 |
| Name | Role | Address |
|---|---|---|
| URBANIAK RODERICK | Treasurer | 13201 Walsingham Road, Largo, FL, 33774 |
| Name | Role | Address |
|---|---|---|
| URBANIAK RODERICK | Director | 13201 Walsingham Road, Largo, FL, 33774 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000048024 | URBANIAK PLASTIC SURGERY & MEDICAL SPA | ACTIVE | 2023-04-15 | 2028-12-31 | No data | 13201 WALSINGHAM ROAD, SUITE 200, LARGO, FL, 33774 |
| G14000028280 | CLEARWATER CENTER FOR COSMETIC SURGERY | EXPIRED | 2014-03-20 | 2019-12-31 | No data | 709 LAKEVIEW ROAD, CLEARWATER, FL, 33758 |
| G14000028282 | CLEARWATER CENTER FOR PLASTIC SURGERY | EXPIRED | 2014-03-20 | 2019-12-31 | No data | 709 LAKEVIEW ROAD, CLEARWATER, FL, 33758 |
| G14000028283 | CENTER FOR COSMETIC AND PLASTIC SURGERY | EXPIRED | 2014-03-20 | 2019-12-31 | No data | 709 LAKEVIEW ROAD, CLEARWATER, FL, 33758 |
| G14000028285 | CLEARWATER COSMETIC CENTER | EXPIRED | 2014-03-20 | 2019-12-31 | No data | 709 LAKEVIEW ROAD, CLEARWATER, FL, 33758 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-26 | 13201 Walsingham Road, Suite 200, Largo, FL 33774 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-26 | 13201 Walsingham Road, Suite 200, Largo, FL 33774 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-05-01 | Hershkowitz & Kunitzer, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-05-01 | 5039 Central Avenue, St. Petersburg, FL 33710-8240 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-16 |
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-01-16 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-01-18 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-01-13 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-03-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
