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  5. MARK W. KAYLIN, M.D., P.A.

MARK W. KAYLIN, M.D., P.A.

Company Details

Entity Name: MARK W. KAYLIN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 12 Jan 1995 (30 years ago)
Date of dissolution: 23 Sep 2022 (2 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 23 Sep 2022 (2 years ago)
Document Number: P95000003144
FEI/EIN Number 65-0544788
Address: 333 NW 70TH AVE., 107, PLANTATION, FL 33317
Mail Address: 333 NW 70TH AVE., 107, PLANTATION, FL 33317
ZIP code: 33317
County: Broward
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2021 650544788 2022-05-25 MARK W. KAYLIN, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2022-05-25
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-25
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2020 650544788 2021-04-14 MARK W. KAYLIN, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2021-04-14
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-14
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2019 650544788 2020-07-20 MARK W. KAYLIN, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2020-07-20
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-20
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2018 650544788 2019-02-15 MARK W. KAYLIN, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2019-02-15
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-15
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2017 650544788 2018-09-25 MARK W. KAYLIN, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2018-09-25
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-25
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2016 650544788 2018-01-24 MARK W. KAYLIN, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2018-01-24
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-01-24
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2015 650544788 2016-06-20 MARK W. KAYLIN, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVE STE 107, PLANTATION, FL, 333172358

Signature of
Role Plan administrator
Date 2016-06-20
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-20
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
MARK W. KAYLIN, M.D., P.A. 401(K) PLAN 2014 650544788 2015-10-15 MARK W. KAYLIN, M.D., P.A. 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 9545810200
Plan sponsor’s address 333 NW 70TH AVENUE, SUITE 107, PLANTATION, FL, 33317

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-15
Name of individual signing MARK KAYLIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
kaylin, mark w Agent 333 nw 70th ave suite, 107, plantation, FL 33317

Director

Name Role Address
KAYLIN, MARK WM.D. Director 333 NW 70TH AVE, #107, PLANTATION, FL 33317

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 No data No data
REGISTERED AGENT NAME CHANGED 2021-02-11 kaylin, mark w No data
REGISTERED AGENT ADDRESS CHANGED 2021-02-11 333 nw 70th ave suite, 107, plantation, FL 33317 No data
CHANGE OF PRINCIPAL ADDRESS 2003-02-26 333 NW 70TH AVE., 107, PLANTATION, FL 33317 No data
CHANGE OF MAILING ADDRESS 2003-02-26 333 NW 70TH AVE., 107, PLANTATION, FL 33317 No data

Documents

Name Date
ANNUAL REPORT 2021-02-11
ANNUAL REPORT 2020-02-26
ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2018-02-08
ANNUAL REPORT 2017-03-23
ANNUAL REPORT 2016-04-13
ANNUAL REPORT 2015-04-30
ANNUAL REPORT 2014-04-10
ANNUAL REPORT 2013-04-30
ANNUAL REPORT 2012-04-22

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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