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  5. JAY J. RUBIN, M.D., P.A.

JAY J. RUBIN, M.D., P.A.

Company Details

Entity Name: JAY J. RUBIN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 03 Oct 1990 (34 years ago)
Date of dissolution: 22 Sep 2017 (7 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2017 (7 years ago)
Document Number: S05892
FEI/EIN Number 59-3029454
Address: 2685 SW 32ND PLACE, SUITE 100, OCALA, FL 34474
Mail Address: JAY J. RUBIN MD, 7327 SE 12TH CIRCLE, OCALA, FL 34480
ZIP code: 34474
County: Marion
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2018 593029454 2019-10-09 JAY J. RUBIN, M.D., P.A. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2017 593029454 2018-10-09 JAY J. RUBIN, M.D., P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2016 593029454 2017-10-06 JAY J. RUBIN, M.D., P.A. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2015 593029454 2016-10-08 JAY J. RUBIN, M.D., P.A. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2014 593029454 2015-10-09 JAY J. RUBIN, M.D., P.A. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing JAY J. RUBIN, M.D.
Valid signature Filed with authorized/valid electronic signature
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2013 593029454 2014-10-10 JAY J. RUBIN, M.D., P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing JAY J. RUBIN, M.D.
Valid signature Filed with authorized/valid electronic signature
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2012 593029454 2013-10-14 JAY J. RUBIN, M.D., P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing JAY J. RUBIN, M.D.
Valid signature Filed with authorized/valid electronic signature
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2011 593029454 2012-10-02 JAY J. RUBIN, M.D., P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643

Signature of
Role Plan administrator
Date 2012-10-02
Name of individual signing JAY J. RUBIN, M.D.
Valid signature Filed with authorized/valid electronic signature
JAY J. RUBIN, M.D., PA. 401K PROFIT SHARING PLAN AND TRUST 2010 593029454 2011-07-28 JAY J. RUBIN, M.D., P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 344717863
Administrator’s telephone number 3527329643

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing JAY J. RUBIN, M.D.
Valid signature Filed with authorized/valid electronic signature
JAY J. RUBIN, M.D., P.A. 401(K) PROFIT SHARING PLAN 2009 593029454 2010-10-13 JAY J. RUBIN, M.D., P.A. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3527329643
Plan sponsor’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 34474

Plan administrator’s name and address
Administrator’s EIN 593029454
Plan administrator’s name JAY J. RUBIN, M.D., P.A.
Plan administrator’s address 2685 S.W. 32ND PLACE, SUITE 100, OCALA, FL, 34474
Administrator’s telephone number 3527329643

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing JAY J. RUBIN, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RUBIN, JAY J. MD Agent 2685 SW 32ND PLACE, SUITE 100, OCALA, FL 34474

President

Name Role Address
RUBIN, JAY J. MD President 2685 SW 32ND PLACE, OCALA, FL 34474

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 No data No data
CHANGE OF MAILING ADDRESS 2009-04-19 2685 SW 32ND PLACE, SUITE 100, OCALA, FL 34474 No data
CHANGE OF PRINCIPAL ADDRESS 2005-04-21 2685 SW 32ND PLACE, SUITE 100, OCALA, FL 34474 No data
REGISTERED AGENT ADDRESS CHANGED 2005-04-21 2685 SW 32ND PLACE, SUITE 100, OCALA, FL 34474 No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J20000155487 ACTIVE 1000000863419 MARION 2020-03-05 2040-03-11 $ 4,285.56 STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156

Documents

Name Date
ANNUAL REPORT 2016-03-25
ANNUAL REPORT 2015-03-18
ANNUAL REPORT 2014-04-01
ANNUAL REPORT 2013-03-28
ANNUAL REPORT 2012-04-03
ANNUAL REPORT 2011-04-08
ANNUAL REPORT 2010-04-05
ANNUAL REPORT 2009-04-19
ANNUAL REPORT 2008-04-21
ANNUAL REPORT 2007-04-21

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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