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  5. CLIFFORD P. CLARK, III, M.D., P.A.

CLIFFORD P. CLARK, III, M.D., P.A.

Company Details

Entity Name: CLIFFORD P. CLARK, III, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 11 Mar 1998 (27 years ago)
Document Number: P98000022848
FEI/EIN Number 593497509
Address: 701 WEST MORSE BLVD., WINTER PARK, FL, 32789, US
Mail Address: 701 WEST MORSE BLVD., WINTER PARK, FL, 32789, US
ZIP code: 32789
County: Orange
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2023 593497509 2024-09-05 CLIFFORD P. CLARK, III, M.D., P.A. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2022 593497509 2023-05-18 CLIFFORD P. CLARK, III, M.D., P.A. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2020 593497509 2021-10-05 CLIFFORD P. CLARK, III, M.D., P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2021-10-05
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-05
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2019 593497509 2020-09-23 CLIFFORD P. CLARK, III, M.D., P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2020-09-23
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-23
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2018 593497509 2019-09-04 CLIFFORD P. CLARK, III, M.D., P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2019-09-04
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-04
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2017 593497509 2018-08-23 CLIFFORD P. CLARK, III, M.D., P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2018-08-23
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-23
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2016 593497509 2017-08-17 CLIFFORD P. CLARK, III, M.D., P.A. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2017-08-17
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-17
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
CLIFFORD P. CLARK, III, M. D. , P. A. 401(K) PLAN 2015 593497509 2016-09-14 CLIFFORD P. CLARK, III, M.D., P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Signature of
Role Plan administrator
Date 2016-09-14
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-14
Name of individual signing CLIFFORD P CLARK, III, MD
Valid signature Filed with authorized/valid electronic signature
CLIFFORD P. CLARK, III, M.D., P.A. 401(K) PLAN 2014 593497509 2015-06-09 CLIFFORD P. CLARK, III, M.D., P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789
CLIFFORD P. CLARK, III, M.D., P.A. 401(K) PLAN 2013 593497509 2014-04-29 CLIFFORD P. CLARK, III, M.D., P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4076295555
Plan sponsor’s address 701 WEST MORSE BLVD., WINTER PARK, FL, 32789

Agent

Name Role Address
Magruder Brock Agent 301 E. Pine Street, Orlando, FL, 32801

President

Name Role Address
CLARK CLIFFORD P President 701 W MORSE BLVD., WINTER PARK, FL, 32789

Secretary

Name Role Address
CLARK CLIFFORD P Secretary 701 W MORSE BLVD., WINTER PARK, FL, 32789

Treasurer

Name Role Address
CLARK CLIFFORD P Treasurer 701 W MORSE BLVD., WINTER PARK, FL, 32789

Director

Name Role Address
CLARK CLIFFORD P Director 701 W MORSE BLVD., WINTER PARK, FL, 32789

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G19000065256 CLARK INSTITUTE FOR AESTHETICS EXPIRED 2019-06-06 2024-12-31 No data 701 W. MORSE BLVD., WINTER PARK, FL, 32789

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2023-11-30 701 WEST MORSE BLVD., WINTER PARK, FL 32789 No data
REGISTERED AGENT NAME CHANGED 2023-11-30 Magruder, Brock No data
REGISTERED AGENT ADDRESS CHANGED 2023-11-30 301 E. Pine Street, Suite 1400, Orlando, FL 32801 No data
CHANGE OF PRINCIPAL ADDRESS 2004-02-09 701 WEST MORSE BLVD., WINTER PARK, FL 32789 No data

Documents

Name Date
ANNUAL REPORT 2024-03-21
AMENDED ANNUAL REPORT 2023-11-30
ANNUAL REPORT 2023-01-31
ANNUAL REPORT 2022-02-17
ANNUAL REPORT 2021-02-01
ANNUAL REPORT 2020-01-28
ANNUAL REPORT 2019-02-19
ANNUAL REPORT 2018-02-02
ANNUAL REPORT 2017-01-16
ANNUAL REPORT 2016-01-25

Related by officers

CLARK CLIFFORD P

THE ORLANDO AESTHETIC INSTITUTE, LLC MORSE BOULEVARD, LLC

Magruder Brock

THE ORLANDO AESTHETIC INSTITUTE, LLC MORSE BOULEVARD, LLC

Related by address

701 WEST MORSE BLVD., WINTER PARK, FL, 32789, US

MORSE BOULEVARD, LLC

701 WEST MORSE BLVD., WINTER PARK, FL, 32789, US

MORSE BOULEVARD, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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