| Entity Name: | DAVID M. KLEIN, M.D., OPHTHALMOLOGIST, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 24 Apr 1998 (27 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | P98000037211 |
| FEI/EIN Number | 65-0829646 |
| Address: | 1600 TAMIAMI TRAIL, STE 101, PORT CHARLOTTE, FL 33948 |
| Mail Address: | 1600 TAMIAMI TRAIL, STE 101, PORT CHARLOTTE, FL 33948 |
| ZIP code: | 33948 |
| County: | Charlotte |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710256110 | 2011-12-14 | 2011-12-14 | 1600 TAMIAMI TRL, SUITE 101, PORT CHARLOTTE, FL, 339481017, US | 1600 TAMIAMI TRL, SUITE 101, PORT CHARLOTTE, FL, 339481017, US | |||||||||||||||||||
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| Phone | +1 941-764-0035 |
| Fax | 9417640037 |
Authorized person
| Name | DR. DAVID MICHAEL KLEIN |
| Role | OWNER/PRESIDENT |
| Phone | 9417640035 |
Taxonomy
| Taxonomy Code | 207W00000X - Ophthalmology Physician |
| License Number | ME0034395 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID M. KLEIN, M.D., OPHTHALMOLOGIST, P.A. EMPLOYEE 401K PROFIT SHARING PLAN | 2010 | 650829646 | 2011-01-28 | DAVID M. KLEIN, M.D., OPHTHALMOLOGIST, P.A. | 3 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 650829646 |
| Plan administrator’s name | DAVID M. KLEIN, M.D., OPHTHALMOLOGIST, P.A. |
| Plan administrator’s address | 1600 TAMIAMI TRAIL, SUITE A, PORT CHARLOTTE, FL, 33948 |
| Administrator’s telephone number | 9417640035 |
Signature of
| Role | Plan administrator |
| Date | 2011-01-28 |
| Name of individual signing | DAVID M. KLEIN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-01-28 |
| Name of individual signing | DAVID M. KLEIN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Business code | 621320 |
| Sponsor’s telephone number | 9417640035 |
| Plan sponsor’s address | 1600 TAMIAMI TRAIL, SUITE A, PORT CHARLOTTE, FL, 33948 |
Plan administrator’s name and address
| Administrator’s EIN | 650829646 |
| Plan administrator’s name | DAVID M. KLEIN, M.D., OPHTHALMOLOGIST, P.A. |
| Plan administrator’s address | 1600 TAMIAMI TRAIL, SUITE A, PORT CHARLOTTE, FL, 33948 |
| Administrator’s telephone number | 9417640035 |
Signature of
| Role | Plan administrator |
| Date | 2010-08-24 |
| Name of individual signing | DAVID M. KLEIN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-08-24 |
| Name of individual signing | DAVID M. KLEIN, M.D. |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| KLEIN, DAVID M, Dr. | Agent | 1600 TAMIAMI TR STE 101, PORT CHARLOTTE, FL 33948 |
| Name | Role | Address |
|---|---|---|
| KLEIN, DAVID M, Dr. | President | 1600 TAMIAMI TR STE 101, PORT CHARLOTTE, FL |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-15 | KLEIN, DAVID M, Dr. | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1999-04-20 | 1600 TAMIAMI TRAIL, STE 101, PORT CHARLOTTE, FL 33948 | No data |
| CHANGE OF MAILING ADDRESS | 1999-04-20 | 1600 TAMIAMI TRAIL, STE 101, PORT CHARLOTTE, FL 33948 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1999-04-20 | 1600 TAMIAMI TR STE 101, PORT CHARLOTTE, FL 33948 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-19 |
| ANNUAL REPORT | 2022-04-13 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-04-07 |
| ANNUAL REPORT | 2019-03-13 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-04-28 |
| ANNUAL REPORT | 2014-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
