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  5. SURGICAL ASSOCIATES OF WEST FLORIDA, P.A.

SURGICAL ASSOCIATES OF WEST FLORIDA, P.A.

Company Details

Entity Name: SURGICAL ASSOCIATES OF WEST FLORIDA, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 15 May 1995 (30 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 07 Jun 2011 (14 years ago)
Document Number: P95000038864
FEI/EIN Number 59-3317557
Address: 1840 MEASE DR, STE 301, SAFETY HARBOR, FL 34695
Mail Address: 1840 MEASE DR, STE 301, SAFETY HARBOR, FL 34695
ZIP code: 34695
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2022 593317557 2023-03-20 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2023-03-20
Name of individual signing THEODORE SMALL
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2021 593317557 2022-03-23 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2022-03-23
Name of individual signing THEODORE SMALL
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2020 593317557 2021-02-23 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2021-02-23
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2019 593317557 2020-06-02 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2020-06-02
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2018 593317557 2019-05-21 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2019-05-21
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2017 593317557 2018-09-13 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2018-09-13
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2016 593317557 2017-09-15 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2017-09-15
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-15
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2015 593317557 2016-06-02 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2016-06-02
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-02
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2014 593317557 2015-10-07 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2015-10-07
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-07
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2013 593317557 2014-10-07 SURGICAL ASSOCIATES OF WEST FLORIDA, P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621111
Sponsor’s telephone number 7277123233
Plan sponsor’s address 1840 MEASE DRIVE, SUITE 301, SAFETY HARBOR, FL, 34695

Signature of
Role Plan administrator
Date 2014-10-07
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-07
Name of individual signing DAVID BERRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Small, Theodore MD Agent 1840 MEASE DR, STE 301, SAFETY HARBOR, FL 34695

Vice President

Name Role Address
ROTH, ROBERT JMD Vice President 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
SCHMIDT, RICK MD Vice President 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
ZUZGA M, ARK DO Vice President 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
Munford, Christina Vice President 1840 MEASE DR, STE 301 SAFETY HARBOR, FL 34695

Director

Name Role Address
ROTH, ROBERT JMD Director 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
SMALL, THEODORE MD Director 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
SCHMIDT, RICK MD Director 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
ZUZGA M, ARK DO Director 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695
Munford, Christina Director 1840 MEASE DR, STE 301 SAFETY HARBOR, FL 34695

President

Name Role Address
SMALL, THEODORE MD President 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695

Chairman

Name Role Address
SMALL, THEODORE MD Chairman 1840 MEASE DR STE 301, SAFETY HARBOR, FL 34695

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2022-01-05 Small, Theodore MD No data
REINSTATEMENT 2011-06-07 No data No data
REGISTERED AGENT ADDRESS CHANGED 2011-06-07 1840 MEASE DR, STE 301, SAFETY HARBOR, FL 34695 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2010-09-24 No data No data
AMENDMENT 2009-09-08 No data No data
CHANGE OF PRINCIPAL ADDRESS 2008-09-08 1840 MEASE DR, STE 301, SAFETY HARBOR, FL 34695 No data
CHANGE OF MAILING ADDRESS 2008-09-08 1840 MEASE DR, STE 301, SAFETY HARBOR, FL 34695 No data
AMENDMENT 2007-08-08 No data No data
AMENDMENT 2007-05-04 No data No data

Documents

Name Date
ANNUAL REPORT 2024-02-10
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-01-05
ANNUAL REPORT 2021-01-14
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-01-12
ANNUAL REPORT 2018-01-12
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-14
ANNUAL REPORT 2015-01-08

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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