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  5. BEVERLY ENCARNACION, M.D., P.A.

BEVERLY ENCARNACION, M.D., P.A. - Florida Company Profile

Company Details

Entity Name: BEVERLY ENCARNACION, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

BEVERLY ENCARNACION, M.D., 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: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 31 Aug 1998 (27 years ago)
Date of dissolution: 28 Mar 2022 (3 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 28 Mar 2022 (3 years ago)
Document Number: P98000076755
FEI/EIN Number 593538815

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 2128 MAIN STREET, DUNEDIN, FL, 34698
Mail Address: 2128 MAIN STREET, DUNEDIN, FL, 34698
ZIP code: 34698
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1306036777 2007-07-31 2017-06-27 2128 MAIN ST, DUNEDIN, FL, 346985604, US 2128 MAIN ST, DUNEDIN, FL, 346985604, US

Contacts
Phone +1 727-736-7733
Fax 7277367740

Authorized person
Name BEVERLY ENCARNACION
Role OWNER/PRESIDENT
Phone 7277367733

Taxonomy
Taxonomy Code 261QP2300X - Primary Care Clinic/Center
License Number ME007280
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BEVERLY ENCARNACION M D P A 401(K) PROFIT SHARING PLAN & TRUST 2020 593538815 2021-04-27 BEVERLY ENCARNACION M D P A 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2021-04-27
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401(K) PROFIT SHARING PLAN & TRUST 2020 593538815 2021-12-03 BEVERLY ENCARNACION M.D., P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7273665290
Plan sponsor’s address 8802 RUSTIC TRAIL CT, TAMPA, FL, 336355604

Signature of
Role Plan administrator
Date 2021-12-03
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401(K) PROFIT SHARING PLAN & TRUST 2019 593538815 2020-06-24 BEVERLY ENCARNACION M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2020-06-24
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2018 593538815 2019-06-25 BEVERLY ENCARNACION M D P A 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2019-06-25
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2017 593538815 2018-05-25 BEVERLY ENCARNACION M D P A 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2018-05-25
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2016 593538815 2017-06-22 BEVERLY ENCARNACION M D P A 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2017-06-22
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2015 593538815 2016-06-24 BEVERLY ENCARNACION M D P A 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2016-06-24
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2014 593538815 2015-07-06 BEVERLY ENCARNACION M D P A 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2015-07-06
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2013 593538815 2014-05-21 BEVERLY ENCARNACION M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2014-05-21
Name of individual signing ELPIDIO LOLENG
Valid signature Filed with authorized/valid electronic signature
BEVERLY ENCARNACION M D P A 401 K PROFIT SHARING PLAN TRUST 2012 593538815 2013-07-12 BEVERLY ENCARNACION M D P A 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7277367733
Plan sponsor’s address 2128 MAIN ST, DUNEDIN, FL, 346985604

Signature of
Role Plan administrator
Date 2013-07-12
Name of individual signing BEVERLY ENCARNACION M D P A
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
ENCARNACION BEVERLY R President 2128 MAIN STREET, DUNEDIN, FL, 34698
LOLENG ELPIDIO M Vice President 2128 MAIN STREET, DUNEDIN, FL, 34698
LOLENG ELPIDIO M Agent 2128 MAIN STREET, DUNEDIN, FL, 34698

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2022-03-28 - -
REGISTERED AGENT NAME CHANGED 2008-03-13 LOLENG, ELPIDIO M -
CHANGE OF PRINCIPAL ADDRESS 2003-08-05 2128 MAIN STREET, DUNEDIN, FL 34698 -
CHANGE OF MAILING ADDRESS 2003-08-05 2128 MAIN STREET, DUNEDIN, FL 34698 -
REGISTERED AGENT ADDRESS CHANGED 2003-08-05 2128 MAIN STREET, DUNEDIN, FL 34698 -
AMENDMENT AND NAME CHANGE 1998-10-19 BEVERLY ENCARNACION, M.D., P.A. -

Documents

Name Date
VOLUNTARY DISSOLUTION 2022-03-28
ANNUAL REPORT 2022-02-11
ANNUAL REPORT 2021-01-30
ANNUAL REPORT 2020-06-05
ANNUAL REPORT 2019-01-26
ANNUAL REPORT 2018-04-09
ANNUAL REPORT 2017-03-14
ANNUAL REPORT 2016-03-11
ANNUAL REPORT 2015-04-23
ANNUAL REPORT 2014-04-21

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5969857706 2020-05-01 0455 PPP 2128 MAIN ST, DUNEDIN, FL, 34698-5604
Loan Status Date 2021-04-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 96505
Loan Approval Amount (current) 96505
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address DUNEDIN, PINELLAS, FL, 34698-5604
Project Congressional District FL-13
Number of Employees 7
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 97345.4
Forgiveness Paid Date 2021-03-17

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Date of last update: 02 Apr 2025

Sources: Florida Department of State

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