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  5. OKALOOSA SURGICAL ASSOCIATES, P.A.

OKALOOSA SURGICAL ASSOCIATES, P.A.

Company Details

Entity Name: OKALOOSA SURGICAL ASSOCIATES, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 10 Jul 1992 (33 years ago)
Document Number: V49820
FEI/EIN Number 593130972
Address: 408 KELLY PLANTATION DRIVE, UNIT 1611, DESTIN, FL, 32541, US
Mail Address: 408 KELLY PLANTATION DRIVE, UNIT 1611, DESTIN, FL, 32541, US
ZIP code: 32541
County: Okaloosa
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OKALOOSA SURGICAL ASSOCIATES, P. A. RETIREMENT PLAN 2018 593130972 2019-07-25 OKALOOSA SURGICAL ASSOCIATES, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD. STE. C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2019-07-25
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P. A. RETIREMENT 2018 593130972 2019-07-25 OKALOOSA SURGICAL ASSOCIATES, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD. STE. C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2019-07-25
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P. A. RETIREMENT PLAN 2017 593130972 2018-10-15 OKALOOSA SURGICAL ASSOCIATES, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD STE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing W MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P. A. RETIREMENT PLAN 2017 593130972 2018-10-15 OKALOOSA SURGICAL ASSOCIATES, P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD STE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-15
Name of individual signing W MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P. A. RETIREMENT PLAN 2016 593130972 2017-10-16 OKALOOSA SURGICAL ASSOCIATES, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD STE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P.A. RETIREMENT PLAN 2015 593130972 2016-10-03 OKALOOSA SURGICAL ASSOCIATES, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD., SUITE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-03
Name of individual signing W.MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P.A. RETIREMENT PLA 2014 593130972 2015-10-14 OKALOOSA SURGICAL ASSOCIATES, P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD., SUITE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-14
Name of individual signing W.MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P.A. RETIREMENT PLA 2013 593130972 2014-10-07 OKALOOSA SURGICAL ASSOCIATES, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD., SUITE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2014-10-07
Name of individual signing W MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-07
Name of individual signing W MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P.A. RETIREMENT PLA 2012 593130972 2013-10-01 OKALOOSA SURGICAL ASSOCIATES, P.A. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD., SUITE C, NICEVILLE, FL, 32578

Signature of
Role Plan administrator
Date 2013-09-30
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
OKALOOSA SURGICAL ASSOCIATES, P.A. RETIREMENT PLA 2011 593130972 2012-10-04 OKALOOSA SURGICAL ASSOCIATES, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 8506786601
Plan sponsor’s address 550 TWIN CITIES BLVD., SUITE C, NICEVILLE, FL, 32578

Plan administrator’s name and address
Administrator’s EIN 593130972
Plan administrator’s name OKALOOSA SURGICAL ASSOCIATES, P.A.
Plan administrator’s address 550 TWIN CITIES BLVD., SUITE C, NICEVILLE, FL, 32578
Administrator’s telephone number 8506786601

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing W. MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-03
Name of individual signing W.MICHAEL HANEY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
HUFF MARCUS AESQ. Agent 501 COMMENDENCIA STREET, PENSACOLA, FL, 32502

President

Name Role Address
HANEY WILLIAM M President 408 KELLY PLANTATION DRIVE, DESTIN, FL, 32541

Secretary

Name Role Address
HANEY WILLIAM M Secretary 408 KELLY PLANTATION DRIVE, DESTIN, FL, 32541

Treasurer

Name Role Address
HANEY WILLIAM M Treasurer 408 KELLY PLANTATION DRIVE, DESTIN, FL, 32541

Director

Name Role Address
HANEY WILLIAM M Director 408 KELLY PLANTATION DRIVE, DESTIN, FL, 32541

Events

Event Type Filed Date Value Description
REINSTATEMENT 2002-04-24 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2000-09-22 No data No data

Related by officers

HUFF MARCUS AESQ.

THE JERRY F. MURDOCK FAMILY FOUNDATION, INC. DESTIN ANESTHESIA, P.A.

Related by address

No related companies by address

Date of last update: 01 Jan 2025

Sources: Florida Department of State

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