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  5. MICHAEL A. SIMON, D.M.D., P.A.

MICHAEL A. SIMON, D.M.D., P.A.

Company Details

Entity Name: MICHAEL A. SIMON, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 19 Nov 1992 (32 years ago)
Date of dissolution: 24 Sep 2021 (3 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 24 Sep 2021 (3 years ago)
Document Number: P92000006564
FEI/EIN Number 65-0377680
Address: 2500 E. HALLANDALE BEACH BLVD., SUITE 700, HALLANDALE, FL 33009
Mail Address: 2500 E. HALLANDALE BEACH BLVD., SUITE 700, HALLANDALE, FL 33009
ZIP code: 33009
County: Broward
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2018 650377680 2019-02-22 MICHAEL A. SIMON, D.M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2019-02-22
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-22
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D. M. D. , P. A. 401(K) PLAN 2018 650377680 2019-03-19 MICHAEL A. SIMON, D.M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2019-03-18
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-03-18
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2017 650377680 2018-05-15 MICHAEL A. SIMON, D.M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2018-05-15
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-15
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2016 650377680 2017-06-02 MICHAEL A. SIMON, D.M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2017-06-01
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-06-01
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2015 650377680 2016-03-21 MICHAEL A. SIMON, D.M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2016-03-21
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-21
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2014 650377680 2015-08-19 MICHAEL A. SIMON, D.M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2015-08-19
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-08-19
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2013 650377680 2014-07-22 MICHAEL A. SIMON, D.M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2014-07-22
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-22
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2012 650377680 2013-04-12 MICHAEL A. SIMON, D.M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Signature of
Role Plan administrator
Date 2013-04-12
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-12
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2011 650377680 2012-05-02 MICHAEL A. SIMON, D.M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Plan administrator’s name and address
Administrator’s EIN 650377680
Plan administrator’s name MICHAEL A. SIMON, D.M.D., P.A.
Plan administrator’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009
Administrator’s telephone number 9544565400

Signature of
Role Plan administrator
Date 2012-05-02
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-02
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
MICHAEL A. SIMON, D.M.D., P.A. 401(K) PLAN 2010 650377680 2011-03-09 MICHAEL A. SIMON, D.M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 9544565400
Plan sponsor’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009

Plan administrator’s name and address
Administrator’s EIN 650377680
Plan administrator’s name MICHAEL A. SIMON, D.M.D., P.A.
Plan administrator’s address 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL, 33009
Administrator’s telephone number 9544565400

Signature of
Role Plan administrator
Date 2011-03-08
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-08
Name of individual signing MICHAEL A. SIMON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SIMON, MICHAEL ADMD Agent 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL 33009

Director

Name Role Address
SIMON, MICHAEL A Director 2500 E. HALLANDALE BEACH BLVD., HALLANDALE, FL 33009

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2021-09-24 No data No data
REGISTERED AGENT ADDRESS CHANGED 2006-01-17 2500 E. HALLANDALE BEACH BLVD., 700, HALLANDALE, FL 33009 No data
CHANGE OF PRINCIPAL ADDRESS 1993-04-23 2500 E. HALLANDALE BEACH BLVD., SUITE 700, HALLANDALE, FL 33009 No data
CHANGE OF MAILING ADDRESS 1993-04-23 2500 E. HALLANDALE BEACH BLVD., SUITE 700, HALLANDALE, FL 33009 No data

Documents

Name Date
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-04-22
ANNUAL REPORT 2018-01-12
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-22
ANNUAL REPORT 2015-01-12
ANNUAL REPORT 2014-01-12
ANNUAL REPORT 2013-01-28
ANNUAL REPORT 2012-01-08
ANNUAL REPORT 2011-01-07

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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