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  5. CYNTHIA L. DERAGON, D.M.D., P.L.

CYNTHIA L. DERAGON, D.M.D., P.L.

Company Details

Entity Name: CYNTHIA L. DERAGON, D.M.D., P.L.
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 01 Jul 2004 (21 years ago)
Document Number: L04000049625
FEI/EIN Number 201319341
Address: 3515 AVOCADO DRIVE, FORT MYERS, FL, 33901, US
Mail Address: 3515 Avocado Drive, FORT MYERS, FL, 33901, US
ZIP code: 33901
County: Lee
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CYNTHIA L. DERAGON, D.M.D., P.L. 401(K) PROFIT SHARING PLAN AND TRUST 2011 201319341 2012-02-14 CYNTHIA L. DERAGON, D.M.D., P.L. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 2392756564
Plan sponsor’s address 34 BARKLEY CIRCLE, FORT MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 201319341
Plan administrator’s name CYNTHIA L. DERAGON, D.M.D., P.L.
Plan administrator’s address 34 BARKLEY CIRCLE, FORT MYERS, FL, 33907
Administrator’s telephone number 2392756564

Signature of
Role Plan administrator
Date 2012-02-14
Name of individual signing CYNTHIA L. DERAGON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-02-14
Name of individual signing CYNTHIA L. DERAGON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
CYNTHIA L. DERAGON, D.M.D., P.L. 401(K) PROFIT SHARING PLAN AND TRUST 2010 201319341 2011-03-09 CYNTHIA L. DERAGON, D.M.D., P.L. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 2392756564
Plan sponsor’s address 34 BARKLEY CIRCLE, FORT MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 201319341
Plan administrator’s name CYNTHIA L. DERAGON, D.M.D., P.L.
Plan administrator’s address 34 BARKLEY CIRCLE, FORT MYERS, FL, 33907
Administrator’s telephone number 2392756564

Signature of
Role Plan administrator
Date 2011-03-09
Name of individual signing CYNTHIA L. DERAGON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-09
Name of individual signing CYNTHIA L. DERAGON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
CYNTHIA L. DERAGON, D.M.D., P.L. 401K PROFIT SHARING PLAN AND TRUST 2009 201319341 2010-07-09 CYNTHIA L. DERAGON, D.M.D., P.L. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621210
Sponsor’s telephone number 2392756564
Plan sponsor’s address 34 BARKLEY CIRCLE, FORT MYERS, FL, 33907

Plan administrator’s name and address
Administrator’s EIN 201319341
Plan administrator’s name CYNTHIA L. DERAGON, D.M.D., P.L.
Plan administrator’s address 34 BARKLEY CIRCLE, FORT MYERS, FL, 33907
Administrator’s telephone number 2392756564

Signature of
Role Plan administrator
Date 2010-07-09
Name of individual signing CYNTHIA L. DERAGON, D.M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-09
Name of individual signing CYNTHIA L. DERAGON, D.M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Deragon Cynthia L Agent 3515 Avocado Drive, FORT MYERS, FL, 33901

Manager

Name Role Address
DERAGON CYNTHIA L Manager 3515 Avocado Drive, FORT MYERS, FL, 33901

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2020-05-21 3515 AVOCADO DRIVE, FORT MYERS, FL 33901 No data
CHANGE OF MAILING ADDRESS 2018-05-18 3515 AVOCADO DRIVE, FORT MYERS, FL 33901 No data
REGISTERED AGENT NAME CHANGED 2013-01-24 Deragon, Cynthia L. No data
REGISTERED AGENT ADDRESS CHANGED 2013-01-24 3515 Avocado Drive, FORT MYERS, FL 33901 No data

Documents

Name Date
ANNUAL REPORT 2024-03-13
ANNUAL REPORT 2023-04-02
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-01-30
ANNUAL REPORT 2020-05-21
ANNUAL REPORT 2019-04-11
ANNUAL REPORT 2018-05-18
ANNUAL REPORT 2017-02-18
ANNUAL REPORT 2016-03-29
ANNUAL REPORT 2015-03-19

Related by officers

DERAGON CYNTHIA L

CJ COTTAGES, LLC PERIODONTAL ASSOCIATES OF SOUTHWEST FLORIDA, P.L.

Related by address

3515 AVOCADO DRIVE, FORT MYERS, FL, 33901, US

CJ COTTAGES, LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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