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  5. BREVARD MEDICAL DERMATOLOGY, P.A.

BREVARD MEDICAL DERMATOLOGY, P.A.

Company Details

Entity Name: BREVARD MEDICAL DERMATOLOGY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 25 Sep 2014 (10 years ago)
Document Number: P14000079514
FEI/EIN Number 36-4796769
Address: 7960 N Wickham Road, MELBOURNE, FL, 32940, US
Mail Address: 7960 N Wickham Road, MELBOURNE, FL, 32940, US
ZIP code: 32940
County: Brevard
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2023 364796769 2024-09-09 BREVARD MEDICAL DERMATOLOGY, P.A. 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 7960 N. WICKHAM RD., STE. 103, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2024-09-09
Name of individual signing MICHAEL S SPICER
Valid signature Filed with authorized/valid electronic signature
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2022 364796769 2023-07-10 BREVARD MEDICAL DERMATOLOGY, P.A. 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 7960 N. WICKHAM RD., STE. 103, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2023-07-10
Name of individual signing MICHAEL S SPICER
Valid signature Filed with authorized/valid electronic signature
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2021 364796769 2022-08-08 BREVARD MEDICAL DERMATOLOGY, P.A. 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 7960 N. WICKHAM RD., STE. 103, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2022-08-08
Name of individual signing MICHAEL S SPICER
Valid signature Filed with authorized/valid electronic signature
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2020 364796769 2021-09-02 BREVARD MEDICAL DERMATOLOGY, P.A. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 7960 N. WICKHAM RD., STE. 103, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2021-09-02
Name of individual signing MICHAEL S SPICER
Valid signature Filed with authorized/valid electronic signature
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2019 364796769 2020-08-03 BREVARD MEDICAL DERMATOLOGY, P.A. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 800 CENTURY MEDICAL DRIVE, SUITE B, TITUSVILLE, FL, 32796
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2018 364796769 2019-09-11 BREVARD MEDICAL DERMATOLOGY, P.A. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 800 CENTURY MEDICAL DRIVE, SUITE B, TITUSVILLE, FL, 32796
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2017 364796769 2018-06-20 BREVARD MEDICAL DERMATOLOGY, P.A. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 800 CENTURY MEDICAL DRIVE, SUITE B, TITUSVILLE, FL, 32796
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2016 364796769 2017-07-13 BREVARD MEDICAL DERMATOLOGY, P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 800 CENTURY MEDICAL DRIVE, SUITE B, TITUSVILLE, FL, 32796
BREVARD MEDICAL DERMATOLOGY, P.A. 401(K) PLAN 2015 364796769 2016-06-22 BREVARD MEDICAL DERMATOLOGY, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 3215677530
Plan sponsor’s address 800 CENTURY MEDICAL DRIVE, SUITE B, TITUSVILLE, FL, 32796

Agent

Name Role
UNITED STATES CORPORATION AGENTS, INC. Agent

President

Name Role Address
SPICER MICHAEL SMD President 7960 N Wickham Road, MELBOURNE, FL, 32940

Secretary

Name Role Address
SPICER MICHAEL SMD Secretary 7960 N Wickham Road, MELBOURNE, FL, 32940

Treasurer

Name Role Address
SPICER MICHAEL SMD Treasurer 7960 N Wickham Road, MELBOURNE, FL, 32940

Director

Name Role Address
SPICER MICHAEL SMD Director 7960 N Wickham Road, MELBOURNE, FL, 32940

Othe

Name Role Address
Thompson Jessica L Othe 7960 N Wickham Road, MELBOURNE, FL, 32940

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-02-18 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 No data
CHANGE OF PRINCIPAL ADDRESS 2021-01-31 7960 N Wickham Road, Suite 103, MELBOURNE, FL 32940 No data
CHANGE OF MAILING ADDRESS 2021-01-31 7960 N Wickham Road, Suite 103, MELBOURNE, FL 32940 No data

Documents

Name Date
ANNUAL REPORT 2025-01-07
ANNUAL REPORT 2024-01-16
ANNUAL REPORT 2023-02-09
ANNUAL REPORT 2022-01-29
ANNUAL REPORT 2021-01-31
ANNUAL REPORT 2020-02-16
ANNUAL REPORT 2019-02-09
ANNUAL REPORT 2018-01-21
ANNUAL REPORT 2017-06-30
ANNUAL REPORT 2016-03-04

Related by officers

Thompson Jessica L

CONE MEDICAL PARK ASSOCIATION, INC. SPICER HOLDINGS, LLC CST CUSTOMS 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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