PALM BEACH ORTHOPAEDIC SPECIALISTS, INC.

Contacts

Phone	+1 561-315-9728
Fax	5614395028
Phone	+1 561-965-5200

Authorized person

Name	DR. GRAHAM FRANK WHITFIELD
Role	PRESIDENT
Phone	5619655200

Taxonomy

Taxonomy Code	261QM2500X - Medical Specialty Clinic/Center
Is Primary	Yes

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1997-01-01
Business code	621111
Sponsor’s telephone number	5619655200
Plan sponsor’s address	2150 S. CONGRESS AVE, WEST PALM BEACH, FL, 334067604

Plan administrator’s name and address

Administrator’s EIN	650687425
Plan administrator’s name	PALM BEACH ORTHOPAEDIC SPECIALISTS, INC.
Plan administrator’s address	2150 S. CONGRESS AVE, WEST PALM BEACH, FL, 334067604
Administrator’s telephone number	5619655200

Signature of

Role	Plan administrator
Date	2011-05-18
Name of individual signing	GRAHAM WHITFIELD
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2011-05-18
Name of individual signing	GRAHAM WHITFIELD
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1997-01-01
Business code	621111
Sponsor’s telephone number	5614331749
Plan sponsor’s address	2150 S. CONGRESS AVE, WEST PALM BEACH, FL, 334067604

Plan administrator’s name and address

Administrator’s EIN	650687425
Plan administrator’s name	PALM BEACH ORTHOPAEDIC SPECIALISTS, INC.
Plan administrator’s address	2150 S. CONGRESS AVE, WEST PALM BEACH, FL, 334067604
Administrator’s telephone number	5614331749

Signature of

Role	Plan administrator
Date	2010-08-13
Name of individual signing	GRAHAM WHITFIELD
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2010-08-13
Name of individual signing	GRAHAM WHITFIELD
Valid signature	Filed with authorized/valid electronic signature