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  5. GARY J. ROSENBAUM, M.D., P.A.

GARY J. ROSENBAUM, M.D., P.A.

Company Details

Entity Name: GARY J. ROSENBAUM, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 10 Feb 1997 (28 years ago)
Document Number: P97000013974
FEI/EIN Number 650720597
Address: 4302 ALTON ROAD, SUITE 740, MIAMI BEACH, FL, 33140, US
Mail Address: 4302 ALTON ROAD, SUITE 740, MIAMI BEACH, FL, 33140, US
ZIP code: 33140
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1932406279 2011-02-23 2011-02-23 4308 ALTON RD, SUITE 720, MIAMI BEACH, FL, 331404556, US 4308 ALTON RD, SUITE 720, MIAMI BEACH, FL, 331404556, US

Contacts
Phone +1 305-538-7726
Fax 3055387725

Authorized person
Name GARY J ROSENBAUM
Role PRESIDENT
Phone 3055387726

Taxonomy
Taxonomy Code 2086S0122X - Plastic and Reconstructive Surgery Physician
License Number ME60122
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN & TRUST 2020 650720597 2021-10-04 GARY J. ROSENBAUM, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4302 ALTON RD SUITE 740, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing GARY J. ROSENBAUM
Valid signature Filed with authorized/valid electronic signature
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN & TRUST 2019 650720597 2020-10-09 GARY J. ROSENBAUM, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4302 ALTON RD SUITE 740, MIAMI BEACH, FL, 33140
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN & TRUST 2018 650720597 2019-09-17 GARY J. ROSENBAUM, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON RD SUITE 720, MIAMI BEACH, FL, 33140
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN & TRUST 2014 650720597 2015-10-14 GARY J. ROSENBAUM, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN & TRUST 2013 650720597 2014-10-06 GARY J. ROSENBAUM, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN & TRUST 2013 650720597 2015-07-21 GARY J. ROSENBAUM, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN AND TRUST 2012 650720597 2014-08-28 GARY J. ROSENBAUM, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2014-08-28
Name of individual signing GARY J. ROSENBAUM
Valid signature Filed with authorized/valid electronic signature
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN AND TRUST 2012 650720597 2013-10-14 GARY J. ROSENBAUM, M.D., P.A. 3
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing GARY J. ROSENBAUM
Valid signature Filed with authorized/valid electronic signature
GARY J. ROSENBAUM, M.D. RETIREMENT PLAN AND TRUST 2011 650720597 2012-10-15 GARY J. ROSENBAUM, M.D., P.A. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 3055387726
Plan sponsor’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140

Plan administrator’s name and address
Administrator’s EIN 650720597
Plan administrator’s name GARY J. ROSENBAUM, M.D., P.A.
Plan administrator’s address 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140
Administrator’s telephone number 3055387726

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing GARY J. ROSENBAUM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROSENBAUM GARY J Agent 4302 ALTON RD, MIAMI BEACH, FL, 33140

Director

Name Role Address
ROSENBAUM GARY J Director 4308 ALTON ROAD, SUITE 720, MIAMI BEACH, FL, 33140

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2018-10-15 4302 ALTON ROAD, SUITE 740, MIAMI BEACH, FL 33140 No data
CHANGE OF PRINCIPAL ADDRESS 2018-03-28 4302 ALTON ROAD, SUITE 740, MIAMI BEACH, FL 33140 No data
REGISTERED AGENT ADDRESS CHANGED 2018-03-28 4302 ALTON RD, STE 740, MIAMI BEACH, FL 33140 No data
REGISTERED AGENT NAME CHANGED 1998-06-03 ROSENBAUM, GARY J No data

Documents

Name Date
ANNUAL REPORT 2024-02-04
ANNUAL REPORT 2023-03-06
ANNUAL REPORT 2022-01-24
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-04-02
ANNUAL REPORT 2018-03-28
ANNUAL REPORT 2017-03-07
ANNUAL REPORT 2016-04-17
ANNUAL REPORT 2015-04-06

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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