| Entity Name: | HAINES CITY INTERNAL MEDICINE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 Sep 1999 (25 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P99000082075 |
| FEI/EIN Number | 650951037 |
| Address: | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Mail Address: | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| ZIP code: | 33844 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HAINES CITY INTERNAL MEDICINE, P.A. 401K PLAN | 2009 | 650951037 | 2010-08-16 | HAINES CITY INTERNAL MEDICINE, P.A. | 14 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 650951037 |
| Plan administrator’s name | HAINES CITY INTERNAL MEDICINE, P.A. |
| Plan administrator’s address | 608 INGRAHAM AVE., HAINES CITY, FL, 33844 |
| Administrator’s telephone number | 8634229562 |
Signature of
| Role | Plan administrator |
| Date | 2010-08-16 |
| Name of individual signing | KAYE STINE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ALLENDE GUILLERMO | Agent | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Name | Role | Address |
|---|---|---|
| ALLENDE GUILLERMO | President | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Name | Role | Address |
|---|---|---|
| ALLENDE GUILLERMO | Director | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| STINE JAY C | Director | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Name | Role | Address |
|---|---|---|
| STINE JAY C | Vice President | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Name | Role | Address |
|---|---|---|
| STINE JAY C | Secretary | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Name | Role | Address |
|---|---|---|
| STINE JAY C | Treasurer | 608 INGRAHAM AVENUE, HAINES CITY, FL, 33844 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-02-01 | 608 INGRAHAM AVENUE, HAINES CITY, FL 33844 | No data |
| CHANGE OF MAILING ADDRESS | 2008-02-01 | 608 INGRAHAM AVENUE, HAINES CITY, FL 33844 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-02-01 | 608 INGRAHAM AVENUE, HAINES CITY, FL 33844 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-13 |
| ANNUAL REPORT | 2014-01-13 |
| ANNUAL REPORT | 2013-01-28 |
| ANNUAL REPORT | 2012-03-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
