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  5. CLEARWATER FAMILY PRACTICE, INC.

CLEARWATER FAMILY PRACTICE, INC.

Company Details

Entity Name: CLEARWATER FAMILY PRACTICE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 31 Oct 1991 (33 years ago)
Document Number: S91044
FEI/EIN Number 593091355
Address: 1217 EWING AVENUE, CLEARWATER, FL, 33756, US
Mail Address: 1217 EWING AVENUE, CLEARWATER, FL, 33756, US
ZIP code: 33756
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLEARWATER FAMILY PRACTICE 401(K) PROFIT SHARING PLAN 2018 593091355 2019-07-08 CLEARWATER FAMILY PRACTICE, INC. 46
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVENUE, CLEARWATER, FL, 33756
CLEARWATER FAMILY PRACTICE 401(K) PROFIT SHARING PLAN 2017 593091355 2018-07-31 CLEARWATER FAMILY PRACTICE, INC. 50
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVENUE, CLEARWATER, FL, 33756
CLEARWATER FAMILY PRACTICE 401(K) PROFIT SHARING PLAN 2016 593091355 2017-09-26 CLEARWATER FAMILY PRACTICE, INC. 45
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVENUE, CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2017-09-25
Name of individual signing CHRISTINA BERTSOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-25
Name of individual signing CHRISTINA BERTSOS
Valid signature Filed with authorized/valid electronic signature
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2015 593091355 2016-09-07 CLEARWATER FAMILY PRACTICE, INC 41
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274663021
Plan sponsor’s address 1217 EWING AVE., CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2016-09-07
Name of individual signing DR. CESAR LARA
Valid signature Filed with authorized/valid electronic signature
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2014 593091355 2015-10-06 CLEARWATER FAMILY PRACTICE, INC. 37
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVE, CLEARWATER, FL, 33756
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2013 593091355 2014-07-09 CLEARWATER FAMILY PRACTICE, INC. 35
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVE, CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2014-07-09
Name of individual signing CESAR LARA, M.D.
Valid signature Filed with authorized/valid electronic signature
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2012 593091355 2013-09-25 CLEARWATER FAMILY PRACTICE, INC. 36
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVE, CLEARWATER, FL, 33756

Signature of
Role Plan administrator
Date 2013-09-25
Name of individual signing CESAR LARA, M.D.
Valid signature Filed with authorized/valid electronic signature
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2011 593091355 2012-09-25 CLEARWATER FAMILY PRACTICE, INC. 37
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVE, CLEARWATER, FL, 33756

Plan administrator’s name and address
Administrator’s EIN 593091355
Plan administrator’s name CLEARWATER FAMILY PRACTICE, INC.
Plan administrator’s address 1217 EWING AVE, CLEARWATER, FL, 33756
Administrator’s telephone number 7274463021

Signature of
Role Plan administrator
Date 2012-09-25
Name of individual signing CESAR LARA, M.D.
Valid signature Filed with authorized/valid electronic signature
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2010 593091355 2011-07-28 CLEARWATER FAMILY PRACTICE, INC. 34
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVE, CLEARWATER, FL, 33756

Plan administrator’s name and address
Administrator’s EIN 593091355
Plan administrator’s name CLEARWATER FAMILY PRACTICE, INC.
Plan administrator’s address 1217 EWING AVE, CLEARWATER, FL, 33756
Administrator’s telephone number 7274463021

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing CESAR LARA, M.D.
Valid signature Filed with authorized/valid electronic signature
CLEARWATER FAMILY PRACTICE 401K PROFIT SHARING PLAN 2009 593091355 2010-06-03 CLEARWATER FAMILY PRACTICE, INC. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7274463021
Plan sponsor’s address 1217 EWING AVE, CLEARWATER, FL, 33756

Plan administrator’s name and address
Administrator’s EIN 593091355
Plan administrator’s name CLEARWATER FAMILY PRACTICE, INC.
Plan administrator’s address 1217 EWING AVE, CLEARWATER, FL, 33756
Administrator’s telephone number 7274463021

Signature of
Role Plan administrator
Date 2010-06-03
Name of individual signing CESAR LARA, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GASSMAN ALAN SEsq. Agent 1245 COURT ST STE 102, CLEARWATER, FL, 34616

Director

Name Role Address
LARA Cesar A Director 1217 EWING AVE, CLEARWATER, FL, 33756

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data
AMENDED AND RESTATEDARTICLES/NAME CHANGE 2005-08-31 CLEARWATER FAMILY PRACTICE, INC. No data

Related by officers

GASSMAN ALAN SEsq.

1245 COURT STREET, L.L.C. BEACHFRONT HOUSE, L.L.C. MCENANY ROOFING, INC. BEACHFRONT CONDO, L.L.C. ALAN S. GASSMAN, P.A. D & D PROPERTY DEVELOPMENT, INC. MARC RUTENBERG HOMES, INC. PAGUSS, L.L.C. SHORELINE LAKE, L.L.C.

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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