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  5. CHARLES B. BARNIV, M.D., P.A.

CHARLES B. BARNIV, M.D., P.A.

Company Details

Entity Name: CHARLES B. BARNIV, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 30 Oct 1998 (26 years ago)
Date of dissolution: 24 Sep 2021 (3 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 24 Sep 2021 (3 years ago)
Document Number: P98000092285
FEI/EIN Number 593539763
Mail Address: 4520 NORTH BRISTOL COURT, NICEVILLE, FL, 32578, US
Address: 623 HIGHWAY 98 E, SUITE 3, DESTIN, FL, 32541, US
ZIP code: 32541
County: Okaloosa
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2020 593539763 2021-06-14 CHARLES B. BARNIV, M.D., P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2021-06-14
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2019 593539763 2020-06-30 CHARLES B. BARNIV, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2020-06-30
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2018 593539763 2019-05-12 CHARLES B. BARNIV, M.D., P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2019-05-12
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2017 593539763 2018-03-05 CHARLES B. BARNIV, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2018-03-05
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2016 593539763 2017-07-19 CHARLES B. BARNIV, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2015 593539763 2016-04-13 CHARLES B. BARNIV, M.D., P.A. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2016-04-13
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature
CHARLES B. BARNIV, M.D., P.A. PROFIT SHARING PLAN AND TRUST 2014 593539763 2015-07-21 CHARLES B. BARNIV, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1999-04-01
Business code 621111
Sponsor’s telephone number 8508375181
Plan sponsor’s address 623 HARBOR BOULEVARD, SUITE 3, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2015-07-21
Name of individual signing CHARLES B. BARNIV, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BARNIV CHARLES B Agent 4520 NORTH BRISTOL COURT, NICEVILLE, FL, 32578

Director

Name Role Address
BARNIV CHARLES BDr. Director 4520 N. BRISTOL CT, NICEVILLE, FL, 32578

Manager

Name Role Address
Barniv Cynthia E Manager 4520 NORTH BRISTOL COURT, NICEVILLE, FL, 32578

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2021-09-24 No data No data
CHANGE OF MAILING ADDRESS 2007-02-10 623 HIGHWAY 98 E, SUITE 3, DESTIN, FL 32541 No data
REGISTERED AGENT NAME CHANGED 2007-02-10 BARNIV, CHARLES B No data
REGISTERED AGENT ADDRESS CHANGED 2007-02-10 4520 NORTH BRISTOL COURT, NICEVILLE, FL 32578 No data
CHANGE OF PRINCIPAL ADDRESS 1999-03-22 623 HIGHWAY 98 E, SUITE 3, DESTIN, FL 32541 No data

Documents

Name Date
ANNUAL REPORT 2020-03-16
ANNUAL REPORT 2019-04-07
ANNUAL REPORT 2018-03-05
ANNUAL REPORT 2017-02-12
ANNUAL REPORT 2016-03-09
ANNUAL REPORT 2015-03-22
ANNUAL REPORT 2014-04-05
ANNUAL REPORT 2013-02-10
ANNUAL REPORT 2012-02-26
ANNUAL REPORT 2011-03-06

Related by officers

Barniv Cynthia E

EMERALD COAST WELLNESS SERVICES, INC. CCB, L.L.C.

BARNIV CHARLES B

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Related by address

4520 NORTH BRISTOL COURT, NICEVILLE, FL, 32578, US

CARIBEAN SEAS, INC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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