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

BEVERLY A. ROSE, D.M.D., P.A.

Company Details

Entity Name: BEVERLY A. ROSE, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 30 Jun 1999 (26 years ago)
Document Number: P99000060197
FEI/EIN Number 593583638
Address: 2755 N WICKHAM RD., STE 101, MELBOURNE, FL, 32935, US
Mail Address: 2755 N WICKHAM RD., STE 101, MELBOURNE, FL, 32935, US
ZIP code: 32935
County: Brevard
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2023 593583638 2024-09-09 BEVERLY A. ROSE, D.M.D. P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2024-09-09
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-09
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2022 593583638 2023-07-18 BEVERLY A. ROSE, D.M.D. P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2023-07-18
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-07-18
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2021 593583638 2022-07-20 BEVERLY A. ROSE, D.M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2022-07-20
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-20
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2020 593583638 2021-05-13 BEVERLY A. ROSE, D.M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2021-05-13
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-13
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2019 593583638 2020-10-08 BEVERLY A. ROSE, D.M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2020-10-08
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-08
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2018 593583638 2019-08-15 BEVERLY A. ROSE, D.M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2019-08-15
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-15
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2017 593583638 2018-08-22 BEVERLY A. ROSE, D.M.D. P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2018-08-22
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-22
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2016 593583638 2017-08-10 BEVERLY A. ROSE, D.M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2017-08-10
Name of individual signing DALE B WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-10
Name of individual signing DALE B WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2015 593583638 2016-05-06 BEVERLY A. ROSE, D.M.D. P.A. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2016-05-06
Name of individual signing DALE B WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-06
Name of individual signing DALE B WILLIAMS
Valid signature Filed with authorized/valid electronic signature
BEVERLY A. ROSE, D.M.D. P.A. 401(K) PROFIT SHARIN PLAN AND TRUST 2014 593583638 2015-09-30 BEVERLY A. ROSE, D.M.D. P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3212594666
Plan sponsor’s address 2755 N. WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2015-09-30
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-30
Name of individual signing DALE WILLIAMS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ANDERSON J. PATRICK Agent 2200 FRONT STREET, MELBOURNE, FL, 32901

Director

Name Role Address
ROSE BEVERLY A Director 4360 WINDOVER WAY, MELBOURNE, FL, 32934

Treasurer

Name Role Address
WILLIAMS DALE B Treasurer 4360 WINDOVER WAY, MELBOURNE, FL, 32934

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G08326900119 EXCEPTIONAL DENTISTRY EXPIRED 2008-11-21 2013-12-31 No data 2755 NORTH WICKHAM ROAD, SUITE 101, MELBOURNE, FL, 32935

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2010-02-23 2200 FRONT STREET, SUITE 301, MELBOURNE, FL 32901 No data
CHANGE OF PRINCIPAL ADDRESS 2006-07-17 2755 N WICKHAM RD., STE 101, MELBOURNE, FL 32935 No data
CHANGE OF MAILING ADDRESS 2006-07-17 2755 N WICKHAM RD., STE 101, MELBOURNE, FL 32935 No data

Documents

Name Date
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-02-14
ANNUAL REPORT 2022-02-03
ANNUAL REPORT 2021-01-26
ANNUAL REPORT 2020-01-22
ANNUAL REPORT 2019-02-28
ANNUAL REPORT 2018-03-01
ANNUAL REPORT 2017-01-17
ANNUAL REPORT 2016-02-08
ANNUAL REPORT 2015-01-14

Related by officers

ANDERSON J. PATRICK

DEMOCRACY DRIVE, LLC APPLIED INTELLIGENCE, LLC WILLIAM C. KEYES, D.M.D., P.A. JAMES S. GAGEN, D.O., P.A. VILLON BRANDS, LLC NAPLES CITY BALLET COMPANY BREVARD COUNTY MEDICAL DIRECTORS ASSOCIATION, LLC ILSE W. BERUBE, D.M.D., P.A. CRE8IVE CR8ON, INC. LE' FOAM, LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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