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UMC TEN BROECK, INC.

UMC TEN BROECK, INC.

Company Details

Entity Name:	UMC TEN BROECK, INC.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Active
Date Filed:	30 Sep 1992 (32 years ago)
Document Number:	V67576
FEI/EIN Number	593167789
Address:	251 West King's Way, Winter Park, FL, 32789, US
Mail Address:	251 West King's Way, Winter Park, FL, 32789, US
ZIP code:	32789
County:	Orange
Place of Formation:	FLORIDA

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

UMC INCENTIVE-BASED RETIREMENT PLAN AND TRUST AGREEMENT

2022

593167789

2023-10-02

UMC TEN BROECK, INC.

76

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	1989-07-01
Business code	621420
Sponsor’s telephone number	4078766820
Plan sponsor’s address	9100 CONROY WINDERMERE ROAD SUITE 2, WINDERMERE, FL, 34786

Signature of

Role	Plan administrator
Date	2023-10-02
Name of individual signing	VALERIE ANDERSON
Valid signature	Filed with authorized/valid electronic signature

Agent

Name	Role	Address
Smith Edward	Agent	251 West King's Way, Winter Park, FL, 32789

DCAS

Name	Role	Address
DIZNEY DONALD R	DCAS	251 West King's Way, Winter Park, FL, 32789

President

Name	Role	Address
DIZNEY DAVID A	President	251 West King's Way, Winter Park, FL, 32789

Chief Executive Officer

Name	Role	Address
DIZNEY DAVID A	Chief Executive Officer	251 West King's Way, Winter Park, FL, 32789

Executive Vice President

Name	Role	Address
Smith Edward	Executive Vice President	251 West King's Way, Winter Park, FL, 32789

Secretary

Name	Role	Address
Smith Edward	Secretary	251 West King's Way, Winter Park, FL, 32789

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G16000130288	TEN BROECK HEALTHCARE	ACTIVE	2016-12-05	2026-12-31	No data	603 MAIN STREET, WINDERMERE, FL, 34786

Events

Event Type	Filed Date	Value	Description
MERGER	2012-11-29	No data	CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 100000126991
AMENDMENT AND NAME CHANGE	2000-05-01	UMC TEN BROECK, INC.	No data

Date of last update: 02 Jan 2025

Sources: Florida Department of State