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  5. GOOD SHEPHERD MEDICAL CLINIC, P.A.

GOOD SHEPHERD MEDICAL CLINIC, P.A.

Company Details

Entity Name: GOOD SHEPHERD MEDICAL CLINIC, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 06 Oct 1993 (31 years ago)
Date of dissolution: 23 Sep 2011 (13 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2011 (13 years ago)
Document Number: P93000070830
FEI/EIN Number 59-3204729
Address: 8425 NORTHCLIFFE BLVD, SUITE 101, SPRING HILL, FL 34606
Mail Address: 8425 NORTHCLIFFE BLVD, SUITE 101, SPRING HILL, FL 34606
ZIP code: 34606
County: Hernando
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2012 593204729 2013-09-05 GOOD SHEPHERD MEDICAL CLINIC, P.A. 62
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Signature of
Role Plan administrator
Date 2013-09-05
Name of individual signing JAMES CASE
Valid signature Filed with authorized/valid electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2011 593204729 2013-09-04 GOOD SHEPHERD MEDICAL CLINIC, P.A. 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2013-09-04
Name of individual signing JAMES CASE
Valid signature Filed with authorized/valid electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-27 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES W CASE
Valid signature Filed with incorrect/unrecognized electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-27 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES CASE
Valid signature Filed with incorrect/unrecognized electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-27 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES CASE
Valid signature Filed with incorrect/unrecognized electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-27 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES W CASE
Valid signature Filed with incorrect/unrecognized electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-28 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES CASE
Valid signature Filed with authorized/valid electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-27 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES CASE
Valid signature Filed with incorrect/unrecognized electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2010 593204729 2011-06-27 GOOD SHEPHERD MEDICAL CLINIC, P.A. 90
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2011-06-27
Name of individual signing JAMES CASE
Valid signature Filed with incorrect/unrecognized electronic signature
GOOD SHEPHERD MEDICAL CLINIC, P.A. EMPLOYEES RETIREMENT PLAN 2009 593204729 2010-07-16 GOOD SHEPHERD MEDICAL CLINIC, P.A. 92
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-05-26
Business code 621111
Sponsor’s telephone number 3526865023
Plan sponsor’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606

Plan administrator’s name and address
Administrator’s EIN 593204729
Plan administrator’s name GOOD SHEPHERD MEDICAL CLINIC, P.A.
Plan administrator’s address 8425 NORTHCLIFFE BLVD. SUITE 101, SPRING HILL, FL, 34606
Administrator’s telephone number 3526865023

Signature of
Role Plan administrator
Date 2010-07-07
Name of individual signing JAMES CASE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CASE, JAMES WMR Agent 8425 NORTHCLIFFE BLVD, SUITE 101, SPRING HILL, FL 34606

President

Name Role Address
BHATIA, ANIL MD President 8425 NORTHCLIFFE BLVD SUITE 108, SPRING HILL, FL 34606

Treasurer

Name Role Address
ROEBUCK MD, BRIAN MD Treasurer 11337 CORTEZ BLVD, BROOKSVILLE, FL 34613

Vice President

Name Role Address
LEE, ROGER MD Vice President 8425 NORTHCLIFFE BLVD SUITE 107, SPRING HILL, FL 34606

Secretary

Name Role Address
GARCIA, LYNDON O Secretary 8425 NORTHCLIFFE BLVD SUITE 110, SPRING HILL, FL 34606

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G08078700032 GOOD SHEPHERD HEARING CENTER EXPIRED 2008-03-18 2013-12-31 No data 8245 NORTHCLIFFE BOULEVARD, SUITE 101, SPRING HILL, FL, 34606

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2011-09-23 No data No data
REGISTERED AGENT ADDRESS CHANGED 2010-04-12 8425 NORTHCLIFFE BLVD, SUITE 101, SPRING HILL, FL 34606 No data
CHANGE OF PRINCIPAL ADDRESS 2004-03-17 8425 NORTHCLIFFE BLVD, SUITE 101, SPRING HILL, FL 34606 No data
CHANGE OF MAILING ADDRESS 2004-03-17 8425 NORTHCLIFFE BLVD, SUITE 101, SPRING HILL, FL 34606 No data
REGISTERED AGENT NAME CHANGED 2003-05-15 CASE, JAMES WMR No data
AMENDED AND RESTATEDARTICLES/NAME CHANGE 1993-12-13 GOOD SHEPHERD MEDICAL CLINIC, P.A. No data

Documents

Name Date
ANNUAL REPORT 2010-04-12
ANNUAL REPORT 2009-04-08
ANNUAL REPORT 2008-01-28
ANNUAL REPORT 2007-04-30
ANNUAL REPORT 2006-01-20
ANNUAL REPORT 2005-07-05
ANNUAL REPORT 2004-03-17
ANNUAL REPORT 2003-05-15
ANNUAL REPORT 2002-05-13
ANNUAL REPORT 2001-05-11

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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