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  5. PAUL S. DECARLO, JR., D.D.S., P.A.

PAUL S. DECARLO, JR., D.D.S., P.A.

Company Details

Entity Name: PAUL S. DECARLO, JR., D.D.S., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 29 Jun 1979 (46 years ago)
Date of dissolution: 25 Sep 2015 (9 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (9 years ago)
Document Number: 628194
FEI/EIN Number 59-1927937
Address: 47 BARKLEY CR. SW, FT MYERS, FL 33907
Mail Address: 47 BARKLEY CR. SW, FT MYERS, FL 33907
ZIP code: 33907
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1457562241 2007-05-24 2008-04-03 47 BARKLEY CIRCLE S.W., FT . MYERS, FL, 339097597, US 47 BARKLEY CIRCLE S.W., FT . MYERS, FL, 339097597, US

Contacts
Phone +1 239-936-5252
Fax 2399360306

Authorized person
Name DR. PAUL S DECARLO JR.
Role DR.
Phone 2399365252

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number DN5468
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PAUL S. DECARLO, JR. D.D.S., P.A. DEFINED BENEFIT PLAN 2014 591927937 2015-08-18 PAUL S. DECARLO, JR. D.D.S., P.A. 10
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2398518750
Plan sponsor’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 591927937
Plan administrator’s name PAUL S. DECARLO, JR. D.D.S., P.A.
Plan administrator’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907
Administrator’s telephone number 2398518750

Signature of
Role Plan administrator
Date 2015-08-18
Name of individual signing PAUL S. DECARLO, JR.
Valid signature Filed with authorized/valid electronic signature
PAUL S. DECARLO, JR. D.D.S., P.A. DEFINED BENEFIT PLAN 2013 591927937 2014-07-28 PAUL S. DECARLO, JR. D.D.S., P.A. 10
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2398518750
Plan sponsor’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 591927937
Plan administrator’s name PAUL S. DECARLO, JR. D.D.S., P.A.
Plan administrator’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907
Administrator’s telephone number 2398518750

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing PAUL S. DECARLO, JR.
Valid signature Filed with authorized/valid electronic signature
PAUL S. DECARLO, JR. D.D.S., P.A. DEFINED BENEFIT PLAN 2012 591927937 2013-10-07 PAUL S. DECARLO, JR. D.D.S., P.A. 10
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2399365252
Plan sponsor’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 591927937
Plan administrator’s name PAUL S. DECARLO, JR. D.D.S., P.A.
Plan administrator’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907
Administrator’s telephone number 2399365252

Signature of
Role Plan administrator
Date 2013-10-07
Name of individual signing PAUL S. DECARLO, JR.
Valid signature Filed with authorized/valid electronic signature
PAUL S. DECARLO, JR. D.D.S., P.A. DEFINED BENEFIT PLAN 2011 591927937 2012-10-04 PAUL S. DECARLO, JR. D.D.S., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2010-01-01
Business code 621210
Sponsor’s telephone number 2399365252
Plan sponsor’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 591927937
Plan administrator’s name PAUL S. DECARLO, JR. D.D.S., P.A.
Plan administrator’s address 47 BARKLEY CIRCLE, FT. MYERS, FL, 33907
Administrator’s telephone number 2399365252

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing PAUL S. DECARLO, JR.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DECARLO, PAUL S., JR. Agent 13990 EAGLE RIDGE LAKES DR, #101, FORT MYERS, FL 33912

President

Name Role Address
DECARLO, PAUL S. JR President 13990 EAGLE RDIGE LAKES DR #101, FORT MYERS, FL 33912

Director

Name Role Address
DECARLO, PAUL S. JR Director 13990 EAGLE RDIGE LAKES DR #101, FORT MYERS, FL 33912

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
REINSTATEMENT 2013-10-05 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2013-09-27 No data No data
REGISTERED AGENT ADDRESS CHANGED 2002-04-16 13990 EAGLE RIDGE LAKES DR, #101, FORT MYERS, FL 33912 No data
CHANGE OF PRINCIPAL ADDRESS 1987-03-06 47 BARKLEY CR. SW, FT MYERS, FL 33907 No data
CHANGE OF MAILING ADDRESS 1987-03-06 47 BARKLEY CR. SW, FT MYERS, FL 33907 No data
REGISTERED AGENT NAME CHANGED 1985-06-28 DECARLO, PAUL S., JR. No data

Documents

Name Date
ANNUAL REPORT 2014-01-26
REINSTATEMENT 2013-10-05
ANNUAL REPORT 2012-03-15
ANNUAL REPORT 2011-03-22
ANNUAL REPORT 2010-01-09
ANNUAL REPORT 2009-04-18
ANNUAL REPORT 2008-01-19
ANNUAL REPORT 2007-03-03
ANNUAL REPORT 2006-02-06
ANNUAL REPORT 2005-03-21

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 05 Feb 2025

Sources: Florida Department of State

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