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  5. MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC

MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC

Company Details

Entity Name: MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 02 Oct 2017 (7 years ago)
Document Number: L17000202670
FEI/EIN Number 82-3044567
Address: 2571 West Eau Gallie Blvd, MELBOURNE, FL, 32935, US
Mail Address: 2571 West Eau Gallie Blvd, Melbourne, FL, 32935, US
ZIP code: 32935
County: Brevard
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MID FLORIDA ORTHO 401(K) PLAN 2023 823044567 2024-09-30 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2024-10-01
Name of individual signing JEFFERY KUGLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO CASH BALANCE PLAN 2023 823044567 2024-10-10 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing KENNETH DECKLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO 401(K) PLAN 2022 823044567 2023-10-09 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing JEFFERY KUGLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO CASH BALANCE PLAN 2022 823044567 2023-10-11 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 1
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing KENNETH DECKLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO 401(K) PLAN 2021 823044567 2022-10-08 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2022-10-08
Name of individual signing JEFFERY KUGLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO CASH BALANCE PLAN 2021 823044567 2022-10-14 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing KENNETH DECKLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO 401(K) PLAN 2020 823044567 2021-10-14 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing JEFFERY KUGLER
Valid signature Filed with authorized/valid electronic signature
MID FLORIDA ORTHO CASH BALANCE PLAN 2020 823044567 2021-10-14 MID FLORIDA ORTHO KISSIMMEE-MELBOURNE, LLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3212215660
Plan sponsor’s address 2571 WEST EAU GALLIE BLVD, SUITE 1, MELBOURNE, FL, 32935

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing KENNETH DECKLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Kugler Jeffrey Agent 2571 West Eau Gallie Blvd, MELBOURNE, FL, 32935

Manager

Name Role Address
KUGLER JEFFREY LM.D. Manager 2571 West Eau Gallie Blvd, Melbourne, FL, 32935

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2025-01-02 Kugler, Jeffrey No data
REGISTERED AGENT ADDRESS CHANGED 2025-01-02 2571 West Eau Gallie Blvd, Suite 1, MELBOURNE, FL 32935 No data
CHANGE OF PRINCIPAL ADDRESS 2020-04-14 2571 West Eau Gallie Blvd, Suite 1, MELBOURNE, FL 32935 No data
CHANGE OF MAILING ADDRESS 2020-04-14 2571 West Eau Gallie Blvd, Suite 1, MELBOURNE, FL 32935 No data

Documents

Name Date
ANNUAL REPORT 2025-01-02
ANNUAL REPORT 2024-01-03
ANNUAL REPORT 2023-04-28
ANNUAL REPORT 2022-03-23
ANNUAL REPORT 2021-01-22
AMENDED ANNUAL REPORT 2020-04-14
ANNUAL REPORT 2020-01-18
ANNUAL REPORT 2019-03-11
ANNUAL REPORT 2018-07-12
Florida Limited Liability 2017-10-02

Related by officers

No related officers

Related by address

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Date of last update: 01 Feb 2025

Sources: Florida Department of State

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