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  5. C. RANDALL HARRELL, M.D., P.A.

C. RANDALL HARRELL, M.D., P.A.

Company Details

Entity Name: C. RANDALL HARRELL, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 19 May 1992 (33 years ago)
Date of dissolution: 11 Apr 2017 (8 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 11 Apr 2017 (8 years ago)
Document Number: V37086
FEI/EIN Number 59-3123367
Address: 34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684
Mail Address: 34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684
ZIP code: 34684
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
C. RANDALL HARRELL, MD, PA DB PENSION PLAN AND TRUST 2013 593123367 2014-07-25 C. RANDALL HARRELL, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7277810818
Plan sponsor’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684

Signature of
Role Plan administrator
Date 2014-07-25
Name of individual signing C. RANDALL HARRELL
Valid signature Filed with authorized/valid electronic signature
C. RANDALL HARRELL, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST 2012 593123367 2013-04-24 C. RANDALL HARRELL, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7277810818
Plan sponsor’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684

Signature of
Role Plan administrator
Date 2013-04-24
Name of individual signing C. RANDALL HARRELL
Valid signature Filed with authorized/valid electronic signature
C. RANDALL HARRELL, M.D., P.A. DEFINED BENEFIT PENSION PLAN AND TRUST 2011 593123367 2012-09-14 C. RANDALL HARRELL, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7277810818
Plan sponsor’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684

Plan administrator’s name and address
Administrator’s EIN 593123367
Plan administrator’s name C. RANDALL HARRELL, M.D., P.A.
Plan administrator’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684
Administrator’s telephone number 7277810818

Signature of
Role Plan administrator
Date 2012-09-14
Name of individual signing MENDY MCKENDRY
Valid signature Filed with authorized/valid electronic signature
C. RANDALL HARRELL, M.D, P.A. DEFINED BENEFIT PENSION PLAN AND TRUST 2010 593123367 2011-10-11 C. RANDALL HARRELL, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7277810818
Plan sponsor’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684

Plan administrator’s name and address
Administrator’s EIN 593123367
Plan administrator’s name C. RANDALL HARRELL, M.D., P.A.
Plan administrator’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684
Administrator’s telephone number 7277810818

Signature of
Role Plan administrator
Date 2011-10-11
Name of individual signing MENDY MCKENDRY
Valid signature Filed with authorized/valid electronic signature
C. RANDALL HARRELL, MD, PA DB PENSION PLAN AND TRUST 2009 593123367 2010-10-15 C. RANDALL HARRELL, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 7277810818
Plan sponsor’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684

Plan administrator’s name and address
Administrator’s EIN 593123367
Plan administrator’s name C. RANDALL HARRELL, M.D., P.A.
Plan administrator’s address 34156 US HIGHWAY 19 NORTH, PALM HARBOR, FL, 34684
Administrator’s telephone number 7277810818

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing MENDY MCKENDRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HARRELL, RANDALL MD Agent 34156 US HWY 19 NORTH, PALM HARBOR, FL 34684

Director

Name Role Address
HARRELL, RANDALL C Director 34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2017-04-11 No data No data
REGISTERED AGENT ADDRESS CHANGED 2005-04-19 34156 US HWY 19 NORTH, PALM HARBOR, FL 34684 No data
REGISTERED AGENT NAME CHANGED 1996-03-05 HARRELL, RANDALL MD No data
AMENDMENT AND NAME CHANGE 1995-12-28 C. RANDALL HARRELL, M.D., P.A. No data
CORPORATE MERGER 1995-12-28 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. CORPORATE MERGER NUMBER 100000008481
CHANGE OF PRINCIPAL ADDRESS 1994-11-21 34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684 No data
CHANGE OF MAILING ADDRESS 1994-11-21 34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684 No data
AMENDED AND RESTATEDARTICLES/NAME CHANGE 1994-11-21 R. RANDALL HARRELL, M.D., P.A. No data

Documents

Name Date
ANNUAL REPORT 2016-01-20
ANNUAL REPORT 2015-01-12
ANNUAL REPORT 2014-01-09
ANNUAL REPORT 2013-01-08
ANNUAL REPORT 2012-01-20
ANNUAL REPORT 2011-01-07
ANNUAL REPORT 2010-04-13
ANNUAL REPORT 2009-03-24
Off/Dir Resignation 2008-07-21
ANNUAL REPORT 2008-04-21

Related by officers

HARRELL, RANDALL MD

HBZ INVESTMENT CORP.

Related by address

34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684

THE FOUNTAIN OF YOUTH INSTITUTE, INC.

34156 U.S. HIGHWAY 19 NORTH, PALM HARBOR, FL 34684

THE FOUNTAIN OF YOUTH INSTITUTE, INC.

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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