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  5. NORBERT CAMACHO DMD PA

NORBERT CAMACHO DMD PA

Company Details

Entity Name: NORBERT CAMACHO DMD PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 31 Jul 2013 (12 years ago)
Document Number: P13000063999
FEI/EIN Number 46-3341346
Mail Address: 3960 UTOPIA CT, MIAMI, FL, 33133, US
Address: 40 SW 13TH ST, SUITE 801, MIAMI, FL, 33130, US
ZIP code: 33130
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689116923 2016-11-16 2016-11-16 1646 SW 16TH ST, MIAMI, FL, 331451516, US 75 SE 6TH ST, M204, MIAMI, FL, 331312886, US

Contacts
Phone +1 305-505-4100
Fax 3057169177

Authorized person
Name DR. NORBERTO CAMACHO JR.
Role DENTIST
Phone 7862661094

Taxonomy
Taxonomy Code 122300000X - Dentist
License Number DN1905
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORBERT CAMACHO DMD PA 401(K) P/S PLAN 2023 463341346 2024-08-01 NORBERT CAMACHO DMD PA 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 7863992191
Plan sponsor’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130

Signature of
Role Plan administrator
Date 2024-08-01
Name of individual signing RYON VAZQUEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-08-01
Name of individual signing RYON VAZQUEZ
Valid signature Filed with authorized/valid electronic signature
NORBERT CAMACHO DMD PA 401(K) P/S PLAN 2022 463341346 2023-09-11 NORBERT CAMACHO DMD PA 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 7863992191
Plan sponsor’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130

Plan administrator’s name and address
Administrator’s EIN 463341346
Plan administrator’s name NORBERT CAMACHO DMD PA
Plan administrator’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130
Administrator’s telephone number 7863992191

Signature of
Role Plan administrator
Date 2023-09-11
Name of individual signing NORBERTO CAMACHO
Valid signature Filed with authorized/valid electronic signature
NORBERT CAMACHO DMD PA 401(K) P/S PLAN 2021 463341346 2023-08-03 NORBERT CAMACHO DMD PA 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 7863992191
Plan sponsor’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130

Plan administrator’s name and address
Administrator’s EIN 463341346
Plan administrator’s name NORBERT CAMACHO DMD PA
Plan administrator’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130
Administrator’s telephone number 7863992191

Signature of
Role Plan administrator
Date 2023-08-03
Name of individual signing NORBERTO CAMACHO
Valid signature Filed with authorized/valid electronic signature
NORBERT CAMACHO DMD PA 401(K) P/S PLAN 2020 463341346 2021-09-05 NORBERT CAMACHO DMD PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 7863992191
Plan sponsor’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130

Plan administrator’s name and address
Administrator’s EIN 463341346
Plan administrator’s name NORBERT CAMACHO DMD PA
Plan administrator’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130
Administrator’s telephone number 7863992191

Signature of
Role Plan administrator
Date 2021-09-05
Name of individual signing NORBERTO CAMACHO
Valid signature Filed with authorized/valid electronic signature
NORBERT CAMACHO DMD PA 401(K) P/S PLAN 2019 463341346 2020-06-13 NORBERT CAMACHO DMD PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621210
Sponsor’s telephone number 7863992191
Plan sponsor’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130

Plan administrator’s name and address
Administrator’s EIN 463341346
Plan administrator’s name NORBERT CAMACHO DMD PA
Plan administrator’s address 40 SW 13TH ST STE 801, MIAMI, FL, 33130
Administrator’s telephone number 7863992191

Signature of
Role Plan administrator
Date 2020-06-13
Name of individual signing NORBERTO CAMACHO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CAMACHO NORBERTO Agent 3960 UTOPIA CT, MIAMI, FL, 33133

President

Name Role Address
CAMACHO NORBERTO President 3960 Utopia Ct, Miami, FL, 33133

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000117661 DENTAL WORLD OF MIAMI ACTIVE 2016-10-30 2026-12-31 No data 40 SW 13TH ST., SUITE 801, MIAMI, FL, 33130

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2021-04-30 40 SW 13TH ST, SUITE 801, MIAMI, FL 33130 No data
REGISTERED AGENT ADDRESS CHANGED 2021-04-30 3960 UTOPIA CT, MIAMI, FL 33133 No data
CHANGE OF PRINCIPAL ADDRESS 2018-04-11 40 SW 13TH ST, SUITE 801, MIAMI, FL 33130 No data

Documents

Name Date
ANNUAL REPORT 2024-03-07
ANNUAL REPORT 2023-03-23
ANNUAL REPORT 2022-04-03
ANNUAL REPORT 2021-04-30
ANNUAL REPORT 2020-03-15
ANNUAL REPORT 2019-01-20
ANNUAL REPORT 2018-01-20
ANNUAL REPORT 2017-03-16
ANNUAL REPORT 2016-02-20
ANNUAL REPORT 2015-03-25

Related by officers

CAMACHO NORBERTO

FUELING FUTURES NOW INCORPORATED ACTIVE PT SERVICES INC.

Related by address

3960 UTOPIA CT, MIAMI, FL, 33133, US

OPM 51 LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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