FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2015
|
650294902
|
2016-07-06
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH STREET,, SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Signature of
Role |
Plan administrator |
Date |
2016-07-06 |
Name of individual signing |
MARCOS SZEINFELD, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2015
|
650294902
|
2016-09-12
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
1
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH STREET,, SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Signature of
Role |
Plan administrator |
Date |
2016-09-12 |
Name of individual signing |
MARCOS SZEINFELD, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2014
|
650294902
|
2015-09-04
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH STREET,, SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Signature of
Role |
Plan administrator |
Date |
2015-09-04 |
Name of individual signing |
MARCOS SZEINFELD, M.D. |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2013
|
650294902
|
2014-09-20
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH STREET,, SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Signature of
Role |
Plan administrator |
Date |
2014-09-20 |
Name of individual signing |
REBECCA TORRES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2012
|
650294902
|
2013-09-13
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
4
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH STREET,, SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Signature of
Role |
Plan administrator |
Date |
2013-09-13 |
Name of individual signing |
REBECCA TORRES |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2011
|
650294902
|
2012-09-24
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
3
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH ST., SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Plan administrator’s name and address
Administrator’s EIN |
650294902 |
Plan administrator’s name |
FORT LAUDERDALE PAIN MEDICINE, INC. |
Plan administrator’s
address |
1930 NORTH EAST 47TH ST., SUITE 300, FORT LAUDERDALE, FL, 333087729 |
Administrator’s telephone number |
9544935048 |
Signature of
Role |
Plan administrator |
Date |
2012-09-24 |
Name of individual signing |
JANESIS DIAZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2010
|
650294902
|
2011-09-30
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
5
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935048
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH ST., SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Plan administrator’s name and address
Administrator’s EIN |
650294902 |
Plan administrator’s name |
FORT LAUDERDALE PAIN MEDICINE, INC. |
Plan administrator’s
address |
1930 NORTH EAST 47TH ST., SUITE 300, FORT LAUDERDALE, FL, 333087729 |
Administrator’s telephone number |
9544935048 |
Signature of
Role |
Plan administrator |
Date |
2011-09-30 |
Name of individual signing |
CAMERON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
FORT LAUDERDALE PAIN MEDICINE, INC. DEFINED BENEFIT PLAN
|
2009
|
650294902
|
2010-09-27
|
FORT LAUDERDALE PAIN MEDICINE, INC.
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1998-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
9544935393
|
Plan sponsor’s
address |
1930 NORTH EAST 47TH ST., SUITE 300, FORT LAUDERDALE, FL, 333087729
|
Plan administrator’s name and address
Administrator’s EIN |
650294902 |
Plan administrator’s name |
FORT LAUDERDALE PAIN MEDICINE, INC. |
Plan administrator’s
address |
1930 NORTH EAST 47TH ST., SUITE 300, FORT LAUDERDALE, FL, 333087729 |
Administrator’s telephone number |
9544935393 |
Signature of
Role |
Plan administrator |
Date |
2010-09-27 |
Name of individual signing |
CAMERON KELLY |
Valid signature |
Filed with authorized/valid electronic signature |
|
|