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  5. ALAN L. MITCHELL, MD, PA

ALAN L. MITCHELL, MD, PA

Company Details

Entity Name: ALAN L. MITCHELL, MD, PA
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 29 Nov 1993 (31 years ago)
Last Event: CANCEL ADM DISS/REV
Event Date Filed: 19 Oct 2004 (20 years ago)
Document Number: P93000082885
FEI/EIN Number 65-0450822
Address: 22023 State Rd 7, Suite 102, Boca Raton, FL 33428
Mail Address: 22023 State Rd 7, Suite 102, Boca Raton, FL 33428
ZIP code: 33428
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1053593194 2007-11-30 2007-12-17 22023 STATE ROAD 7, SUITE 102, BOCA RATON, FL, 334283401, US 22023 STATE ROAD 7, SUITE 102, BOCA RATON, FL, 334283401, US

Contacts
Phone +1 561-451-0655
Fax 5614512660

Authorized person
Name DR. ALAN LEWIS MITCHELL I
Role OWNER
Phone 5614510655

Taxonomy
Taxonomy Code 207W00000X - Ophthalmology Physician
License Number ME57319
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS
Number 10754
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2020 650450822 2021-09-01 ALAN L MITCHELL MD PA 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 334283401

Signature of
Role Plan administrator
Date 2021-09-01
Name of individual signing ALAN L MITCHELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-01
Name of individual signing ALAN L MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2020 650450822 2021-09-24 ALAN L MITCHELL MD PA 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 334283401

Signature of
Role Plan administrator
Date 2021-09-24
Name of individual signing ALAN L MITCHELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-24
Name of individual signing ALAN L MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2019 650450822 2020-08-20 ALAN L MITCHELL MD PA 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 334283401

Signature of
Role Plan administrator
Date 2020-08-20
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-20
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2018 650450822 2019-09-09 ALAN L MITCHELL MD PA 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 334283401

Signature of
Role Plan administrator
Date 2019-09-09
Name of individual signing ALAN L MITCHELL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-09
Name of individual signing ALAN L MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L. MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2017 650450822 2018-10-15 ALAN L MITCHELL MD PA 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 334283401

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2016 650450822 2017-07-26 ALAN L MITCHELL MD PA 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 33428

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2015 650450822 2016-10-10 ALAN L MITCHELL MD PA 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 33428

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2014 650450822 2015-07-30 ALAN L MITCHELL MD PA 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 33428

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature
ALAN L MITCHELL MD PA EMPLOYEES SAVINGS TRUST 2013 650450822 2014-10-08 ALAN L MITCHELL MD PA 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621320
Sponsor’s telephone number 5614510655
Plan sponsor’s address 22023 STATE RD 7, BOCA RATON, FL, 33428

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing ALAN MITCHELL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
MITCHELL, ALAN L Agent 5866 WINDSOR TER, BOCA RATON, FL 33496

Treasurer

Name Role Address
Shea, Kathy Treasurer 22023 State Rd 7, Suite 102 Boca Raton, FL 33428

Chief Financial Officer

Name Role Address
Shea, Kathy Chief Financial Officer 22023 State Rd 7, Suite 102 Boca Raton, FL 33428

Director

Name Role Address
Mitchell, Alan L. Director 5866 Windsor Terrace, Boca Raton, FL 33496

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-03-22 22023 State Rd 7, Suite 102, Boca Raton, FL 33428 No data
CHANGE OF MAILING ADDRESS 2024-03-22 22023 State Rd 7, Suite 102, Boca Raton, FL 33428 No data
REGISTERED AGENT NAME CHANGED 2005-04-01 MITCHELL, ALAN L No data
CANCEL ADM DISS/REV 2004-10-19 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2004-10-01 No data No data
REGISTERED AGENT ADDRESS CHANGED 2000-01-14 5866 WINDSOR TER, BOCA RATON, FL 33496 No data

Documents

Name Date
ANNUAL REPORT 2024-03-22
ANNUAL REPORT 2023-03-09
ANNUAL REPORT 2022-02-27
ANNUAL REPORT 2021-02-01
ANNUAL REPORT 2020-03-18
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-03-07
ANNUAL REPORT 2017-03-19
ANNUAL REPORT 2016-03-28
ANNUAL REPORT 2015-03-25

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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