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  5. UROLOGY CONSULTANTS, INC.

UROLOGY CONSULTANTS, INC.

Company Details

Entity Name: UROLOGY CONSULTANTS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 05 Sep 2018 (6 years ago)
Document Number: P18000075309
FEI/EIN Number 83-1856185
Address: 6817 Southpoint Parkway, JACKSONVILLE, FL, 32216, US
Mail Address: 12620-3 BEACH BLVD, 254, JACKSONVILLE, FL, 32246, US
ZIP code: 32216
County: Duval
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UROLOGY CONSULTANTS 401(K) PROFIT SHARING PLAN 2015 593180786 2016-10-10 UROLOGY CONSULTANTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 WEST STATE ROAD 434, SUITE 302, LONGWOOD, FL, 32750

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PLAN 2015 593180786 2016-12-08 UROLOGY CONSULTANTS 0
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 621399
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 W.S.R. 434 #302, LONGWOOD, FL, 32750

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2016-12-08
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PLAN 2015 593180786 2016-09-26 UROLOGY CONSULTANTS 4
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 621399
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 W.S.R. 434 #302, LONGWOOD, FL, 32750

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2016-09-26
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PROFIT SHARING PLAN 2014 593180786 2015-10-15 UROLOGY CONSULTANTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 WEST STATE ROAD 434, SUITE 302, LONGWOOD, FL, 32750

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PLAN 2014 593180786 2015-06-29 UROLOGY CONSULTANTS 8
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 621399
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 W.S.R. 434 #302, LONGWOOD, FL, 32750

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2015-06-29
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PROFIT SHARING PLAN 2013 593180786 2014-10-14 UROLOGY CONSULTANTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 WEST STATE ROAD 434, SUITE 302, LONGWOOD, FL, 32750

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-14
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PLAN 2013 593180786 2014-07-23 UROLOGY CONSULTANTS 22
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 621399
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 W.S.R. 434 #302, LONGWOOD, FL, 32750

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PROFIT SHARING PLAN 2012 593180786 2013-10-11 UROLOGY CONSULTANTS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 WEST STATE ROAD 434, SUITE 302, LONGWOOD, FL, 32750

Signature of
Role Plan administrator
Date 2013-10-11
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-11
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PLAN 2012 593180786 2013-09-29 UROLOGY CONSULTANTS 0
File View Page
Three-digit plan number (PN) 101
Effective date of plan 2012-01-01
Business code 621399
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 W.S.R. 434 #302, LONGWOOD, FL, 32750

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2013-09-29
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
UROLOGY CONSULTANTS 401(K) PROFIT SHARING PLAN 2011 593180786 2013-10-11 UROLOGY CONSULTANTS 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 4073320777
Plan sponsor’s address 515 WEST STATE ROAD 434, SUITE 302, LONGWOOD, FL, 32750

Plan administrator’s name and address
Administrator’s EIN 593180786
Plan administrator’s name UROLOGY CONSULTANTS
Plan administrator’s address 515 WEST STATE ROAD 434, SUITE 302, LONGWOOD, FL, 32750
Administrator’s telephone number 4073320777

Signature of
Role Plan administrator
Date 2013-10-11
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-11
Name of individual signing E. JAKE JACOBO, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WILLIAMS NEEKA W Agent 6817 Southpoint Parkway, JACKSONVILLE, FL, 32216

President

Name Role Address
WILLIAMS CHRISTOPHER RMD President 6817 Southpoint Parkway, JACKSONVILLE, FL, 32216

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-19 6817 Southpoint Parkway, Unit 1802, JACKSONVILLE, FL 32216 No data
REGISTERED AGENT ADDRESS CHANGED 2024-04-19 6817 Southpoint Parkway, Unit 1802, JACKSONVILLE, FL 32216 No data

Documents

Name Date
ANNUAL REPORT 2024-04-19
ANNUAL REPORT 2023-04-13
ANNUAL REPORT 2022-04-04
ANNUAL REPORT 2021-04-08
ANNUAL REPORT 2020-03-31
ANNUAL REPORT 2019-03-11
Domestic Profit 2018-09-05

Related by officers

WILLIAMS NEEKA W

I.K.C., LLC

Related by address

6817 Southpoint Parkway, JACKSONVILLE, FL, 32216, US

ORP FRANCHISE SYSTEMS, INC. CARDIAC VISION LLC AGILITY HR GROUP, INC. CARDIACVISION4U LLC FLORIDA MORTGAGE CORP R. HERNDON CPA, PLLC DGT LAW, PLLC THAYVER HOLDINGS LLC

12620-3 BEACH BLVD, 254, JACKSONVILLE, FL, 32246, US

LEGACY LEADERS, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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