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  5. CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A.

CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A.

Company Details

Entity Name: CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 04 Nov 1976 (48 years ago)
Date of dissolution: 22 Jan 2015 (10 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 22 Jan 2015 (10 years ago)
Document Number: 517945
FEI/EIN Number 59-1704089
Address: 1895 KINGSLEY AV, SUITE 701, ORANGE PARK, FL 32073
Mail Address: 1895 KINGSLEY AV, SUITE 701, ORANGE PARK, FL 32073
ZIP code: 32073
County: Clay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1346513876 2012-02-14 2012-02-14 1895 KINGSLEY AVE, SUITE 701, ORANGE PARK, FL, 320734466, US 1895 KINGSLEY AVE, SUITE 701, ORANGE PARK, FL, 320734466, US

Contacts
Phone +1 904-272-2525
Fax 9042722700

Authorized person
Name DR. CARLOS L. ESQUIVIA-MUNOZ
Role OWNER
Phone 9042722525

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
License Number ME0021696
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. PROFIT SHARING PLAN 2014 591704089 2015-01-05 CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 621111
Sponsor’s telephone number 9042722525
Plan sponsor’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2015-01-05
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. PROFIT SHARING PLAN 2013 591704089 2014-08-14 CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 621111
Sponsor’s telephone number 9042722525
Plan sponsor’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2014-08-14
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. PROFIT SHARING PLAN 2012 591704089 2013-07-12 CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 621111
Sponsor’s telephone number 9042722525
Plan sponsor’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073

Signature of
Role Plan administrator
Date 2013-07-12
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. PROFIT SHARING PLAN 2011 591704089 2012-07-12 CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 621111
Sponsor’s telephone number 9042722525
Plan sponsor’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 591704089
Plan administrator’s name CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A.
Plan administrator’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042722525

Signature of
Role Plan administrator
Date 2012-07-12
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-12
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. PROFIT SHARING PLAN 2010 591704089 2011-07-19 CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 621111
Sponsor’s telephone number 9042722525
Plan sponsor’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 591704089
Plan administrator’s name CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A.
Plan administrator’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042722525

Signature of
Role Plan administrator
Date 2011-07-19
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-19
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
CARLOS L. ESQUIVIA-MUNOZ, M.D., P.A. PROFIT SHARING PLAN 2009 591704089 2010-10-05 CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1981-04-01
Business code 621111
Sponsor’s telephone number 9042722525
Plan sponsor’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073

Plan administrator’s name and address
Administrator’s EIN 591704089
Plan administrator’s name CARLOS L. ESQUIVIA-MUNOZ, M.D.,P.A.
Plan administrator’s address 1895 KINGSLEY AVENUE STE 701, ORANGE PARK, FL, 32073
Administrator’s telephone number 9042722525

Signature of
Role Plan administrator
Date 2010-10-05
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-05
Name of individual signing CARLOS L. ESQUIVIA-MUNOZ, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ESQUIVIA-MUNOZ, CARLOS L. Agent 1895 KINGSLEY AVENUE, SUITE 701, ORANGE PARK, FL 32073

Director

Name Role Address
ESQUIVIA-MUNOZ, CARLOS L Director 1895 KINGSLEY AVE., STE 701, ORANGE PARK, FL 32073

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2015-01-22 No data No data
CHANGE OF PRINCIPAL ADDRESS 2012-04-10 1895 KINGSLEY AV, SUITE 701, ORANGE PARK, FL 32073 No data
REGISTERED AGENT ADDRESS CHANGED 2012-04-10 1895 KINGSLEY AVENUE, SUITE 701, ORANGE PARK, FL 32073 No data
CHANGE OF MAILING ADDRESS 2010-03-12 1895 KINGSLEY AV, SUITE 701, ORANGE PARK, FL 32073 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2015-01-22
ANNUAL REPORT 2014-03-10
ANNUAL REPORT 2013-02-21
ANNUAL REPORT 2012-04-10
ANNUAL REPORT 2011-03-10
ANNUAL REPORT 2010-03-12
ANNUAL REPORT 2009-02-21
ANNUAL REPORT 2008-01-24
ANNUAL REPORT 2007-02-05
ANNUAL REPORT 2006-04-03

Related by officers

ESQUIVIA-MUNOZ, CARLOS L

ESQUIVIA LEASING, INC.

Related by address

No related companies by address

Date of last update: 05 Feb 2025

Sources: Florida Department of State

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