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  5. MARC B KLEIN DPM PA

MARC B KLEIN DPM PA

Company Details

Entity Name: MARC B KLEIN DPM PA
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 12 May 2022 (3 years ago)
Date of dissolution: 22 Sep 2023 (a year ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2023 (a year ago)
Document Number: P22000040230
FEI/EIN Number 65-0068990
Address: 8680 CARMEL MOUNTAIN WAY, BOYNTON BEACH, FL 33473
Mail Address: 8680 CARMEL MOUNTAIN WAY, BOYNTON BEACH, FL 33473
ZIP code: 33473
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1629261508 2007-08-23 2008-07-11 7050 W. PALMETTO PARK ROAD, #18, BOCA RATON, FL, 33433, US 7050 W PALMETTO PARK RD STE 18, BOCA RATON, FL, 334333462, US

Contacts
Phone +1 561-447-7571
Fax 5614477574

Authorized person
Name JILL KLEIN
Role OFFICE MANAGER
Phone 5614477571

Taxonomy
Taxonomy Code 213ES0000X - Sports Medicine Podiatrist
License Number PO1505
State FL
Is Primary Yes

Other Provider Identifiers
Issuer RAILROAD MEDICARE ID
Number 480019906
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARC B. KLEIN, DPM, PA 401K PROFIT SHARING PLAN 2015 650068990 2016-10-11 MARC B. KLEIN, DPM, PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433

Signature of
Role Plan administrator
Date 2016-10-11
Name of individual signing MARC B. KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-11
Name of individual signing MARC B. KLEIN
Valid signature Filed with authorized/valid electronic signature
MARC B. KLEIN, DPM, PA 401K PROFIT SHARING PLAN 2014 650068990 2015-07-20 MARC B. KLEIN, DPM, PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433

Signature of
Role Plan administrator
Date 2015-07-20
Name of individual signing MARC B. KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-20
Name of individual signing MARC B. KLEIN
Valid signature Filed with authorized/valid electronic signature
MARC B. KLEIN, DPM, PA 401K PROFIT SHARING PLAN 2013 650068990 2014-07-29 MARC B. KLEIN, DPM, PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433

Signature of
Role Plan administrator
Date 2014-07-29
Name of individual signing MARC KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-29
Name of individual signing MARC KLEIN
Valid signature Filed with authorized/valid electronic signature
MARC B. KLEIN, DPM, PA 401K PROFIT SHARING PLAN 2012 650068990 2013-09-19 MARC B. KLEIN, DPM, PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433

Signature of
Role Plan administrator
Date 2013-09-19
Name of individual signing MARC KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-19
Name of individual signing MARC KLEIN
Valid signature Filed with authorized/valid electronic signature
MARC B. KLEIN, DPM, PA 401K PROFIT SHARING PLAN 2011 650068990 2012-07-12 MARC B. KLEIN, DPM, PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 650068990
Plan administrator’s name MARC B. KLEIN, DPM, PA
Plan administrator’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433
Administrator’s telephone number 5614477571

Signature of
Role Plan administrator
Date 2012-07-12
Name of individual signing MARC B. KLEIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-12
Name of individual signing MARC B. KLEIN
Valid signature Filed with authorized/valid electronic signature
MARC B. KLEIN, DPM, PA 401K PROFIT SHARING PLAN 2010 650068990 2011-09-01 MARC B. KLEIN, DPM, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 650068990
Plan administrator’s name MARC B. KLEIN, DPM, PA
Plan administrator’s address 7050 WEST PALMETTO PARK ROAD, SUITE 18, BOCA RATON, FL, 33433
Administrator’s telephone number 5614477571

Signature of
Role Plan administrator
Date 2011-09-01
Name of individual signing MARC B KLEIN DPM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-01
Name of individual signing MARC B KLEIN DPM
Valid signature Filed with authorized/valid electronic signature
MARC B. KLEIN DPM PA 401K PROFIT SHARING PLAN 2009 650068990 2010-08-05 MARC B KLEIN DPM PA 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5614477571
Plan sponsor’s address 7050 W PALMETTO PARK RD SUITE 18, BOCA RATON, FL, 33433

Plan administrator’s name and address
Administrator’s EIN 650068990
Plan administrator’s name MARC B KLEIN DPM PA
Plan administrator’s address 7050 W PALMETTO PARK RD SUITE 18, BOCA RATON, FL, 33433
Administrator’s telephone number 5614477571

Signature of
Role Plan administrator
Date 2010-08-05
Name of individual signing MARC B KLEIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MANES, MICHAEL B Agent 950 S. PINE ISLAND DRIVE, SUITE 150, PLANTATION, FL 33324

Director

Name Role Address
KLEIN, MARC B Director 8680 CARMEL MOUNTAIN WAY, BOYNTON BEACH, FL 33473

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 No data No data
CHANGE OF PRINCIPAL ADDRESS 2022-06-01 8680 CARMEL MOUNTAIN WAY, BOYNTON BEACH, FL 33473 No data
CHANGE OF MAILING ADDRESS 2022-06-01 8680 CARMEL MOUNTAIN WAY, BOYNTON BEACH, FL 33473 No data

Documents

Name Date
Domestic Profit 2022-05-12

Related by officers

MANES, MICHAEL B

PETROLINE TRANSPORT, LLC AQUA CHARTERS, LLC ROWE-YOUNG, L.L.C. VIRTUAL TECHNOLOGY LICENSING, L.L.C. SATA & ASSOCIATES, INC. A36, L.L.C. KIRTMED, INC. EATS, L.L.C. PRECISION TORQUE CONVERTERS OF SOUTH FLORIDA, L.L.C. JAC, L.L.C.

Related by address

No related companies by address

Date of last update: 12 Jan 2025

Sources: Florida Department of State

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