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  5. ALL FAMILY CLINIC OF DAYTONA BEACH, INC.

ALL FAMILY CLINIC OF DAYTONA BEACH, INC.

Company Details

Entity Name: ALL FAMILY CLINIC OF DAYTONA BEACH, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 05 Aug 1996 (29 years ago)
Date of dissolution: 16 Feb 2017 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 16 Feb 2017 (8 years ago)
Document Number: P96000065299
FEI/EIN Number 593393219
Address: 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
Mail Address: 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
ZIP code: 32117
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1902203243 2014-12-02 2014-12-02 1040 MASON AVE, DAYTONA BEACH, FL, 321174612, US 3546 SAINT JOHNS BLUFF RD S, JACKSONVILLE, FL, 322242713, US

Contacts
Phone +1 386-248-0107
Fax 3862480109
Phone +1 386-299-0847

Authorized person
Name DR. FRANK S ALVAREZ JR.
Role MANAGING MEMBER
Phone 3862480107

Taxonomy
Taxonomy Code 207T00000X - Neurological Surgery Physician
Is Primary No
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary No
Taxonomy Code 208100000X - Physical Medicine & Rehabilitation Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 401(K) PLAN 2013 593393219 2014-08-28 ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 3862480107
Plan sponsor’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 401(K) PLAN 2013 593393219 2014-04-18 ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 3862480107
Plan sponsor’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 401(K) PLAN 2012 593393219 2013-05-24 ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 3862480107
Plan sponsor’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

Signature of
Role Plan administrator
Date 2013-05-24
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-24
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 401(K) PLAN 2011 593393219 2012-02-20 ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 3862480107
Plan sponsor’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

Plan administrator’s name and address
Administrator’s EIN 593393219
Plan administrator’s name ALL FAMILY CLINIC OF DAYTONA BEACH, INC.
Plan administrator’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
Administrator’s telephone number 3862480107

Signature of
Role Plan administrator
Date 2012-02-20
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-02-20
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 401(K) PLAN 2010 593393219 2011-09-19 ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 3862480107
Plan sponsor’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

Plan administrator’s name and address
Administrator’s EIN 593393219
Plan administrator’s name ALL FAMILY CLINIC OF DAYTONA BEACH, INC.
Plan administrator’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
Administrator’s telephone number 3862480107

Signature of
Role Plan administrator
Date 2011-09-19
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-19
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 401(K) PLAN 2009 593393219 2010-09-13 ALL FAMILY CLINIC OF DAYTONA BEACH, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 3862480107
Plan sponsor’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

Plan administrator’s name and address
Administrator’s EIN 593393219
Plan administrator’s name ALL FAMILY CLINIC OF DAYTONA BEACH, INC.
Plan administrator’s address 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117
Administrator’s telephone number 3862480107

Signature of
Role Plan administrator
Date 2010-09-13
Name of individual signing JULIE BURGESS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ALVAREZ FRANK S Agent 1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

President

Name Role Address
ALVAREZ FRANK S President 707 HENSEL HILL EAST, PORT ORANGE, FL, 32127

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2017-02-16 No data No data
REGISTERED AGENT NAME CHANGED 2006-08-21 ALVAREZ, FRANK SJR MD No data
CHANGE OF MAILING ADDRESS 2004-01-12 1040 MASON AVENUE, DAYTONA BEACH, FL 32117 No data
REGISTERED AGENT ADDRESS CHANGED 2004-01-12 1040 MASON AVENUE, DAYTONA BEACH, FL 32117 No data
REINSTATEMENT 2000-11-06 No data No data
CHANGE OF PRINCIPAL ADDRESS 2000-11-06 1040 MASON AVENUE, DAYTONA BEACH, FL 32117 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2000-09-22 No data No data
CORPORATE MERGER 1997-10-31 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. CORPORATE MERGER NUMBER 100000014921
CORPORATE MERGER 1997-03-28 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 4. CORPORATE MERGER NUMBER 100000013081

Documents

Name Date
ANNUAL REPORT 2016-04-26
ANNUAL REPORT 2015-02-20
ANNUAL REPORT 2014-01-21
ANNUAL REPORT 2013-01-22
ANNUAL REPORT 2012-01-11
ANNUAL REPORT 2011-02-10
ANNUAL REPORT 2010-06-01
ANNUAL REPORT 2009-02-23
ANNUAL REPORT 2008-02-25
ANNUAL REPORT 2007-03-29

Related by officers

ALVAREZ FRANK S

LOST MAGICS LLC ADVANTACARE MEDICAL ASSOCIATES, LLC ADVANTACARE HOLDINGS, LLC MIDNIGHTANGELSONLINESTORE "LLC"

Related by address

1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

ADVANTACARE MEDICAL ASSOCIATES, LLC MASON AVENUE, LLC

1040 MASON AVENUE, DAYTONA BEACH, FL, 32117

ADVANTACARE MEDICAL ASSOCIATES, LLC MASON AVENUE, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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