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  5. WINTER HAVEN ORAL SURGERY, P.A.

WINTER HAVEN ORAL SURGERY, P.A.

Company Details

Entity Name: WINTER HAVEN ORAL SURGERY, P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 29 Feb 1980 (45 years ago)
Last Event: NAME CHANGE AMENDMENT
Event Date Filed: 08 May 2009 (16 years ago)
Document Number: 657665
FEI/EIN Number 59-1971577
Address: 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880
Mail Address: 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880
ZIP code: 33880
County: Polk
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2023 591971577 2024-02-28 WINTER HAVEN ORAL SURGERY, P.A. 15
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880
WINTER HAVEN ORAL SURGERY, P.A. EMPLOYEES PROFIT SHARING PLAN & TRUST 2023 591971577 2024-09-27 WINTER HAVEN ORAL SURGERY, P.A. 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1980-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE SUITE 14A, WINTER HAVEN, FL, 33880

Signature of
Role Plan administrator
Date 2024-09-27
Name of individual signing RIGOBERTO CORNEJO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-27
Name of individual signing RIGOBERTO CORNEJO
Valid signature Filed with authorized/valid electronic signature
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2023 591971577 2024-02-27 WINTER HAVEN ORAL SURGERY, P.A. 15
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2022 591971577 2024-02-23 WINTER HAVEN ORAL SURGERY, P.A. 17
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880
WINTER HAVEN ORAL SURGERY, P.A. EMPLOYEES PROFIT SHARING PLAN & TRUST 2022 591971577 2023-10-02 WINTER HAVEN ORAL SURGERY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1980-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE SUITE 14A, WINTER HAVEN, FL, 33880

Signature of
Role Plan administrator
Date 2023-10-02
Name of individual signing RIGOBERTO CORNEJO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-02
Name of individual signing RIGOBERTO CORNEJO
Valid signature Filed with authorized/valid electronic signature
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2022 591971577 2024-02-23 WINTER HAVEN ORAL SURGERY, P.A. 17
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2022 591971577 2023-03-21 WINTER HAVEN ORAL SURGERY, P.A. 17
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880
WINTER HAVEN ORAL SURGERY, P.A. EMPLOYEES PROFIT SHARING PLAN & TRUST 2021 591971577 2022-09-18 WINTER HAVEN ORAL SURGERY, P.A. 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1980-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE SUITE 14A, WINTER HAVEN, FL, 33880

Signature of
Role Plan administrator
Date 2022-09-18
Name of individual signing RIGOBERTO CORNEJO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-18
Name of individual signing RIGOBERTO CORNEJO
Valid signature Filed with authorized/valid electronic signature
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2021 591971577 2022-08-19 WINTER HAVEN ORAL SURGERY, P.A. 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880
WINTER HAVEN ORAL SURGERY, P.A. CASH BALANCE PLAN 2020 591971577 2021-07-19 WINTER HAVEN ORAL SURGERY, P.A. 18
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-03-01
Business code 621210
Sponsor’s telephone number 8632947648
Plan sponsor’s address 400 AVE. K SE STE 14A, WINTER HAVEN, FL, 33880

Agent

Name Role Address
RIGOBERTO CORNEJO Agent 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880

Director

Name Role Address
CORNEJO, RIGOBERTO Director 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880

President

Name Role Address
CORNEJO, RIGOBERTO President 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2015-03-20 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880 No data
CHANGE OF MAILING ADDRESS 2015-03-20 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880 No data
REGISTERED AGENT ADDRESS CHANGED 2015-03-20 400 AVENUE K.,S.E. STE 14A, WINTER HAVEN, FL 33880 No data
REGISTERED AGENT NAME CHANGED 2011-06-03 RIGOBERTO CORNEJO No data
NAME CHANGE AMENDMENT 2009-05-08 WINTER HAVEN ORAL SURGERY, P.A. No data

Documents

Name Date
ANNUAL REPORT 2024-04-23
ANNUAL REPORT 2023-03-08
ANNUAL REPORT 2022-04-21
ANNUAL REPORT 2021-02-12
ANNUAL REPORT 2020-02-21
ANNUAL REPORT 2019-04-10
ANNUAL REPORT 2018-04-25
ANNUAL REPORT 2017-03-21
ANNUAL REPORT 2016-02-12
ANNUAL REPORT 2015-03-20

Related by officers

No related officers

Related by address

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Date of last update: 05 Feb 2025

Sources: Florida Department of State

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