Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Collier
    4. ›
  4. 34103
    5. ›
  5. LISA D. ZACK, M.D., P.A.

LISA D. ZACK, M.D., P.A.

Company Details

Entity Name: LISA D. ZACK, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 06 Dec 1989 (35 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 11 Mar 2010 (15 years ago)
Document Number: L35115
FEI/EIN Number 65-0156881
Address: LISA D. ZACK MD PA, 801 ANCHOR RODE DR #100, NAPLES, FL 34103
Mail Address: LISA D. ZACK MD PA, 801 ANCHOR RODE DR #100, NAPLES, FL 34103
ZIP code: 34103
County: Collier
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FLORIDA COASTAL DERMATOLOGY 401(K) PROFIT SHARING PLAN 2022 650156881 2024-02-02 LISA D. ZACK, M.D., P.A. 24
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2022-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2024-02-02
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY CASH BALANCE PLAN 2022 650156881 2024-01-23 LISA D. ZACK, M.D., P.A. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2024-01-23
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY CASH BALANCE PLAN 2021 650156881 2023-02-08 LISA D. ZACK, M.D., P.A. 22
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2023-02-08
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY CASH BALANCE PLAN 2020 650156881 2021-09-28 LISA D. ZACK, M.D., P.A. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103
FLORIDA COASTAL DERMATOLOGY 401(K) PROFIT SHARING PLAN 2019 650156881 2020-11-24 LISA D. ZACK, M.D., P.A. 20
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2020-11-24
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY CASH BALANCE PLAN 2019 650156881 2020-10-15 LISA D. ZACK, M.D., P.A. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing JAMES RALEY
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY 401(K) PROFIT SHARING PLAN 2019 650156881 2020-10-14 LISA D. ZACK, M.D., P.A. 21
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY 401(K) PROFIT SHARING PLAN 2018 650156881 2019-07-30 LISA D. ZACK, M.D., P.A. 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY CASH BALANCE PLAN 2018 650156881 2019-07-30 LISA D. ZACK, M.D., P.A. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature
FLORIDA COASTAL DERMATOLOGY 401(K) PROFIT SHARING PLAN 2017 650156881 2018-10-04 LISA D. ZACK, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2392631717
Plan sponsor’s address 801 ANCHOR RODE DRIVE, #100, NAPLES, FL, 34103

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing KIMBERLY WEIGERT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ZACK, LISA D, Dr. Agent 801 ANCHOR RODE DR #100, NAPLES, FL 34103

Director

Name Role Address
ZACK, LISA D, Dr. Director 801 ANCHOR RODE DR #100, NAPLES, FL 34103

Vice President

Name Role Address
Kovach, Bradley T, Dr. Vice President 801 Anchor Rode Drive, Suite 100 NAPLES, FL 34103

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G99299900176 FLORIDA COASTAL DERMATOLOGY ASSOCIATES ACTIVE 1999-10-27 2029-12-31 No data 801 ANCHOR RODE DRIVE, SUITE 100, NAPLES, FL, 34103

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2017-01-09 ZACK, LISA D, Dr. No data
REINSTATEMENT 2010-03-11 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2006-02-15 LISA D. ZACK MD PA, 801 ANCHOR RODE DR #100, NAPLES, FL 34103 No data
CHANGE OF MAILING ADDRESS 2006-02-15 LISA D. ZACK MD PA, 801 ANCHOR RODE DR #100, NAPLES, FL 34103 No data
REGISTERED AGENT ADDRESS CHANGED 2006-02-15 801 ANCHOR RODE DR #100, NAPLES, FL 34103 No data

Documents

Name Date
ANNUAL REPORT 2024-01-31
ANNUAL REPORT 2023-02-02
ANNUAL REPORT 2022-02-01
ANNUAL REPORT 2021-01-19
ANNUAL REPORT 2020-01-23
ANNUAL REPORT 2019-02-08
ANNUAL REPORT 2018-01-16
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-01-19
ANNUAL REPORT 2015-01-21

Related by officers

ZACK, LISA D, Dr.

FLORIDA DERMATOPATHOLOGY LABORATORY, INC. FLORIDA COASTAL SURGERY CENTER, INC.

Kovach, Bradley T, Dr.

FLORIDA COASTAL SURGERY CENTER, INC.

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated