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  5. CALVIN BLOUNT, JR., M.D., P.A.

CALVIN BLOUNT, JR., M.D., P.A.

Company Details

Entity Name: CALVIN BLOUNT, JR., M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 28 Jan 1999 (26 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 02 Jan 2004 (21 years ago)
Document Number: P99000009827
FEI/EIN Number 593553504
Address: 4012 Commons Dr. W, Suite 120, Destin, FL, 32541, US
Mail Address: 4012 Commons Dr. W, Suite 120, 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
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2023 593553504 2024-06-28 CALVIN BLOUNT, JR, M.D., P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8504245474
Plan sponsor’s address 4012 COMMONS DRIVE W, SUITE 120, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2024-06-28
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2022 593553504 2023-06-29 CALVIN BLOUNT, JR, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8504245474
Plan sponsor’s address 4012 COMMONS DRIVE W, SUITE 120, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2023-06-29
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2021 593553504 2022-12-18 CALVIN BLOUNT, JR, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8504245474
Plan sponsor’s address 4012 COMMONS DRIVE W, SUITE 120, DESTIN, FL, 32541

Signature of
Role Plan administrator
Date 2022-12-18
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2019 593553504 2021-02-09 CALVIN BLOUNT, JR, M.D., P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8504245474
Plan sponsor’s address 4012 COMMONS DRIVE WEST, SUITE 120, DESTIN, FL, 32551

Signature of
Role Plan administrator
Date 2021-02-09
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2018 593553504 2019-08-30 CALVIN BLOUNT, JR, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8508374844
Plan sponsor’s address 12607 HIGHWAY 98 WEST, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2019-08-30
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2017 593553504 2018-10-05 CALVIN BLOUNT, JR, M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8508374844
Plan sponsor’s address 12607 HIGHWAY 98 WEST, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2016 593553504 2017-11-22 CALVIN BLOUNT, JR, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8508374844
Plan sponsor’s address 12607 HIGHWAY 98 WEST, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2017-11-22
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2015 593553504 2016-10-08 CALVIN BLOUNT, JR, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8508374844
Plan sponsor’s address 12607 HIGHWAY 98 WEST, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2016-10-08
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2014 593553504 2015-06-30 CALVIN BLOUNT, JR, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8508374844
Plan sponsor’s address 12607 HIGHWAY 98 WEST, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2015-06-30
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature
CALVIN BLOUNT, JR, M.D., P.A. 401(K) PLAN 2013 593553504 2014-07-18 CALVIN BLOUNT, JR, M.D., P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-28
Business code 621111
Sponsor’s telephone number 8508374844
Plan sponsor’s address 12607 HIGHWAY 98 WEST, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2014-07-18
Name of individual signing CALVIN BLOUNT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
HILL COLEMAN LLC Agent

Director

Name Role Address
BLOUNT CALVIN LDr. Director 347 AVALON BLVD, MIRAMAR BEACH, FL, 32550

President

Name Role Address
BLOUNT CALVIN LDr. President 347 AVALON BLVD, MIRAMAR BEACH, FL, 32550

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2021-03-11 HILL COLEMAN LLC No data
REGISTERED AGENT ADDRESS CHANGED 2021-03-11 12805 US HWY 98 E, STE B202, INLET BEACH, FL 32461 No data
CHANGE OF PRINCIPAL ADDRESS 2020-05-29 4012 Commons Dr. W, Suite 120, Destin, FL 32541 No data
CHANGE OF MAILING ADDRESS 2020-05-29 4012 Commons Dr. W, Suite 120, Destin, FL 32541 No data
REINSTATEMENT 2004-01-02 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2003-09-19 No data No data

Documents

Name Date
ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2023-03-02
ANNUAL REPORT 2022-02-14
ANNUAL REPORT 2021-03-11
ANNUAL REPORT 2020-05-29
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-04-03
ANNUAL REPORT 2017-04-17
ANNUAL REPORT 2016-04-29
ANNUAL REPORT 2015-04-30

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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