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  5. KELLER & GOODMAN, M.D., P.A.

KELLER & GOODMAN, M.D., P.A.

Company Details

Entity Name: KELLER & GOODMAN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 01 Jul 1994 (31 years ago)
Last Event: AMENDMENT AND NAME CHANGE
Event Date Filed: 21 Nov 1995 (29 years ago)
Document Number: P94000050197
FEI/EIN Number 593247502
Address: 1879 NIGHTINGALE LN, SUITE C2, TAVARES, FL, 32778, US
Mail Address: 1879 NIGHTINGALE LN, SUITE C2, TAVARES, FL, 32778, US
ZIP code: 32778
County: Lake
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2023 593247502 2024-10-11 KELLER & GOODMAN, M. D. , P. A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LN, STE C2, TAVARES, FL, 32778

Signature of
Role Plan administrator
Date 2024-10-11
Name of individual signing BERNIE GOODMAN
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2022 593247502 2023-10-10 KELLER & GOODMAN, M. D. , P. A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-10
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2021 593247502 2022-10-11 KELLER & GOODMAN, M. D. , P. A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2020 593247502 2021-10-05 KELLER & GOODMAN, M. D. , P. A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2019 593247502 2020-09-30 KELLER & GOODMAN, M. D. , P. A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2020-09-30
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2018 593247502 2019-10-02 KELLER & GOODMAN, M. D. , P. A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN 2017 593247502 2018-10-04 KELLER & GOODMAN, M. D. , P. A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427776
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing JEFFREY A GOODMAN, MD
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN AND TRUST 2016 593247502 2018-01-17 KELLER & GOODMAN, M. D. , P. A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427748
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2018-01-17
Name of individual signing JEFFREY A. GOODMAN
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN AND TRUST 2015 593247502 2016-10-14 KELLER & GOODMAN, M. D. , P. A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427748
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing JEFFREY A. GOODMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-14
Name of individual signing JEFFREY A. GOODMAN
Valid signature Filed with authorized/valid electronic signature
KELLER & GOODMAN, M. D. , P. A. 401(K) PROFIT SHARING PLAN AND TRUST 2014 593247502 2015-10-13 KELLER & GOODMAN, M. D. , P. A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 3527427748
Plan sponsor’s address 1879 NIGHTINGALE LANE, SUITE C-2, TAVARES, FL, 327784363

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing JEFFREY A. GOODMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-13
Name of individual signing JEFFREY A. GOODMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Goodman Bernard Agent 1879 NIghtingale LN, Tavares, FL, 32778

President

Name Role Address
GOODMAN JEFFREY A President 1879 NIGHTINGALE LN., SUITE C2, TAVARES, FL, 32778

Director

Name Role Address
GOODMAN JEFFREY A Director 1879 NIGHTINGALE LN., SUITE C2, TAVARES, FL, 32778

Secretary

Name Role Address
GOODMAN BERNARD E Secretary 1879 NIGHTINGALE LANE, SUITE C2, TAVARES, FL

Treasurer

Name Role Address
GOODMAN BERNARD E Treasurer 1879 NIGHTINGALE LANE, SUITE C2, TAVARES, FL

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-06-24 Goodman , Bernard No data
REGISTERED AGENT ADDRESS CHANGED 2020-06-24 1879 NIghtingale LN, Suite C-2, Tavares, FL 32778 No data
CHANGE OF PRINCIPAL ADDRESS 1997-02-11 1879 NIGHTINGALE LN, SUITE C2, TAVARES, FL 32778 No data
CHANGE OF MAILING ADDRESS 1997-02-11 1879 NIGHTINGALE LN, SUITE C2, TAVARES, FL 32778 No data
AMENDMENT AND NAME CHANGE 1995-11-21 KELLER & GOODMAN, M.D., P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-04-24
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-04-14
ANNUAL REPORT 2020-06-24
ANNUAL REPORT 2019-04-18
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-04-05
ANNUAL REPORT 2016-04-11
ANNUAL REPORT 2015-03-26

Related by officers

GOODMAN JEFFREY A

HOMETEAM REALTY FORT LAUDERDALE, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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