Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Broward
    4. ›
  4. 33324
    5. ›
  5. SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.

SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. - Florida Company Profile

Company Details

Entity Name: SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 28 Apr 1998 (27 years ago)
Last Event: AMENDMENT
Event Date Filed: 11 Jan 2018 (7 years ago)
Document Number: P98000038119
FEI/EIN Number 650829651

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 220 SW 84 Avenue, Suite 102, Plantation, FL, 33324, US
Mail Address: 220 SW 84 Avenue, Suite 102, Plantation, FL, 33324, US
ZIP code: 33324
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1487624771 2006-01-26 2024-09-24 220 SW 84TH AVE STE 102, PLANTATION, FL, 333242729, US 220 SW 84TH AVE STE 102, PLANTATION, FL, 333242729, US

Contacts
Phone +1 954-349-2345
Fax 9546411086
Phone +1 954-720-1530
Fax 9547206540

Authorized person
Name CHRYSTAL A. HERRERA
Role CREDENTIALING COORDINATOR
Phone 3052186965

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes
Taxonomy Code 207XS0106X - Orthopaedic Hand Surgery Physician
Is Primary No
Taxonomy Code 207XX0005X - Sports Medicine (Orthopaedic Surgery) Physician
Is Primary No
Taxonomy Code 208100000X - Physical Medicine & Rehabilitation Physician
Is Primary No
Taxonomy Code 363A00000X - Physician Assistant
Is Primary No

Other Provider Identifiers
Issuer MEDICAID - SYDNEE R. BRIN, PA-C
Number 108857600
State FL
Issuer MEDICAID - PAUL R. BUCHANAN, PA-C
Number 002603000
State FL
Issuer MEDICAID - HANNA E. HEMMATI, PA-C
Number 1558022426
State FL
Issuer MEDICAID - ALEXANDER J. BERTOT, M.D.
Number 002398700
State FL
Issuer MEDICAID
Number 002876700
State FL
Issuer MEDICAID - ERIC D. BRONSON, PA-C
Number 002602400
State FL
Issuer MEDICAID - DAVID SHENASSA, M.D.
Number 002462700
State FL
Issuer MEDICAID - JESSE T. CROSNO, PA-C
Number 118651300
State FL
Issuer MEDICAID - ALFRED A. DESIMONE, M.D.
Number 002615000
State FL
Issuer MEDICAID - PEDRO A. RICART HOFFIZ, M.D.
Number 119205700
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2017 650829651 2018-06-19 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 9546411073
Plan sponsor’s address 1608 TOWN CENTER BLVD, WESTON, FL, 33326
SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2016 650829651 2017-09-26 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621111
Sponsor’s telephone number 9546411069
Plan sponsor’s address 2101 N COMMERCE PARKWAY, WESTON, FL, 33326
SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2015 650829651 2016-10-13 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2137 N COMMERCE PARKWAY, WESTON, FL, 33326
SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2014 650829651 2015-07-21 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 93
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2137 N COMMERCE PARKWAY, WESTON, FL, 33326
SPORTS MEDICINE ASSOCIATION OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2013 650829651 2014-07-01 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326
SPORTS MEDICINE ASSOCIATION OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2012 650829651 2013-07-16 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 80
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326

Signature of
Role Plan administrator
Date 2013-07-16
Name of individual signing ALFRED DESIMONE, M.D.
Valid signature Filed with authorized/valid electronic signature
SPORTS MEDICINE ASSOCIATION OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2011 650829651 2012-07-24 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 72
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326

Plan administrator’s name and address
Administrator’s EIN 650829651
Plan administrator’s name SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.
Plan administrator’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326
Administrator’s telephone number 9543897825

Signature of
Role Plan administrator
Date 2012-07-24
Name of individual signing ALFRED DESIMONE, M.D.
Valid signature Filed with authorized/valid electronic signature
SPORTS MEDICINE ASSOCIATION OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2010 650829651 2011-10-12 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 58
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326

Plan administrator’s name and address
Administrator’s EIN 650829651
Plan administrator’s name SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.
Plan administrator’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326
Administrator’s telephone number 9543897825

Signature of
Role Plan administrator
Date 2011-10-12
Name of individual signing KIM WICKER
Valid signature Filed with authorized/valid electronic signature
SPORTS MEDICINE ASSOCIATION OF SOUTH FLORIDA, P.A. 401(K) RETIREMENT PLAN 2009 650829651 2010-06-07 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-05-01
Business code 621111
Sponsor’s telephone number 9543897825
Plan sponsor’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326

Plan administrator’s name and address
Administrator’s EIN 650829651
Plan administrator’s name SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.
Plan administrator’s address 2149 N. COMMERCE PARKWAY, WESTON, FL, 33326
Administrator’s telephone number 9543897825

Signature of
Role Plan administrator
Date 2010-06-07
Name of individual signing KIM WICKER
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
DeSimone Alfred A Director 220 S.W 84th Avenue, Plantation, FL, 33324
Bertot Alexander J President 220 S.W. 84th Avenue, Plantation, FL, 33324
Shenassa David Director 220 S. W. 84th Avenue, Plantation, FL, 33324
DESIMONE ALFRED A Agent 220 SW 84th Avenue, Plantation, FL, 33324

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000107250 SOUTH FLORIDA INSTITUTE OF SPORTS MEDICINE ACTIVE 2021-08-18 2026-12-31 - 1600 TOWN CENTER BLVD, SUITE C, WESTON, FL, 33326

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2024-01-17 220 SW 84th Avenue, Suite 102, Plantation, FL 33324 -
CHANGE OF PRINCIPAL ADDRESS 2023-10-31 220 SW 84 Avenue, Suite 102, Plantation, FL 33324 -
CHANGE OF MAILING ADDRESS 2023-10-31 220 SW 84 Avenue, Suite 102, Plantation, FL 33324 -
AMENDMENT 2018-01-11 - -
NAME CHANGE AMENDMENT 2009-05-13 SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A. -
REGISTERED AGENT NAME CHANGED 2006-04-11 DESIMONE, ALFRED A -
NAME CHANGE AMENDMENT 2001-12-19 DESIMONE & MOYA, M.D., P.A. -

Documents

Name Date
ANNUAL REPORT 2025-01-07
ANNUAL REPORT 2024-01-17
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-04-21
AMENDED ANNUAL REPORT 2021-10-21
ANNUAL REPORT 2021-04-09
ANNUAL REPORT 2020-04-22
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-04-10
Amendment 2018-01-11

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1769757207 2020-04-15 0455 PPP 1608 TOWN CENTER BLVD, FORT LAUDERDALE, FL, 33326-3635
Loan Status Date 2021-04-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 612100
Loan Approval Amount (current) 612100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17124
Servicing Lender Name City National Bank of Florida
Servicing Lender Address 100 SE 2nd St, MIAMI, FL, 33131
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address FORT LAUDERDALE, BROWARD, FL, 33326-3635
Project Congressional District FL-25
Number of Employees 80
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 17124
Originating Lender Name City National Bank of Florida
Originating Lender Address MIAMI, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 617499.9
Forgiveness Paid Date 2021-03-11

Companies related by officers

DESIMONE ALFRED A

AA DESIMONE HOLDINGS, LLC - Inactive
Florida Limited Liability Co. (2004 - 2008)
AA DESIMONE HOLDINGS, LLC - Inactive
Florida Limited Liability Co. (2004 - 2008)
ORTHOPAEDIC & PODIATRIC CONSULTANTS OF FLORIDA, INC. - Inactive
Domestic Profit (1995 - 2006)
ORTHOPAEDIC & PODIATRIC CONSULTANTS OF FLORIDA, INC. - Inactive
Domestic Profit (1995 - 2006)
ORTHOPAEDIC & PODIATRIC CONSULTANTS OF FLORIDA, INC. - Inactive
Domestic Profit (1995 - 2006)
STRESS-A-LESS, INC. - Inactive
Domestic Profit (1996 - 1998)
LEX D PALMS, LLC - Inactive
Florida Limited Liability Co. (2003 - 2015)
LEX D PALMS, LLC - Inactive
Florida Limited Liability Co. (2003 - 2015)
DOZO, INC. - Inactive
Domestic Profit (2000 - 2004)
DOZO, INC. - Inactive
Domestic Profit (2000 - 2004)

Companies related by address

No other companies in our directory share the same address as SPORTS MEDICINE ASSOCIATES OF SOUTH FLORIDA, P.A.

Date of last update: 03 Apr 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated