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  5. LAWRENCE R. BERGMAN, M.D., P.A.

LAWRENCE R. BERGMAN, M.D., P.A.

Company Details

Entity Name: LAWRENCE R. BERGMAN, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 13 Aug 1990 (35 years ago)
Date of dissolution: 07 May 2015 (10 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 07 May 2015 (10 years ago)
Document Number: L95368
FEI/EIN Number 65-0221837
Address: 10115 W FOREST HILL BLVD, STE 303, WELLINGTON, FL 33414
Mail Address: 10115 W FOREST HILL BLVD, STE 303, WELLINGTON, FL 33414
ZIP code: 33414
County: Palm Beach
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAWRENCE BERGMAN MD,PA PROFIT SHARING PLAN 2015 650221837 2016-10-10 LAWRENCE R. BERGMAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 5617985565
Plan sponsor’s address 10115 W. FOREST HILL BLVD., STE 303, WELLINGTON, FL, 33414

Signature of
Role Plan administrator
Date 2016-09-12
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-12
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
LAWRENCE BERGMAN MDPA PROFIT SHARING PLAN 2014 650221837 2015-10-09 LAWRENCE R. BERGMAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 5617985565
Plan sponsor’s address 10115 W. FOREST HILL BLVD., STE 303, WELLINGTON, FL, 33414

Signature of
Role Plan administrator
Date 2015-10-09
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-09
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
LAWRENCE BERGMAN MD,PA PROFIT SHARING PLAN 2013 650221837 2014-10-06 LAWRENCE R. BERGMAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 5617985565
Plan sponsor’s address 10115 W. FOREST HILL BLVD., STE 303, WELLINGTON, FL, 33414

Signature of
Role Plan administrator
Date 2014-10-06
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-06
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
LAWRENCE BERGMAN MD,PA PROFIT SHARING PLAN 2012 650221837 2013-10-09 LAWRENCE R. BERGMAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 5617985565
Plan sponsor’s address 10115 W. FOREST HILL BLVD., STE 303, WELLINGTON, FL, 33414

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-09
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
LAWRENCE BERGMAN MD,PA PROFIT SHARING PLAN 2011 650221837 2012-10-12 LAWRENCE R. BERGMAN, M.D., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 5617985565
Plan sponsor’s address 10115 W. FOREST HILL BLVD., STE 303, WELLINGTON, FL, 33414

Plan administrator’s name and address
Administrator’s EIN 650221837
Plan administrator’s name LAWRENCE R. BERGMAN, M.D., P.A.
Plan administrator’s address 10115 W. FOREST HILL BLVD., STE 303, WELLINGTON, FL, 33414
Administrator’s telephone number 5617985565

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-08
Name of individual signing LAWRENCE R. BERGMAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BERGMAN, LAWRENCE R, Dr. Agent 10115 WEST FOREST HILL BLVD, STE 303, WELLINGTON, FL 33414

President

Name Role Address
BERGMAN, LAWRENCE R President 2165 AMESBURY CIRCLE, WELLINGTON, FL 33414

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2015-05-07 No data No data
REGISTERED AGENT NAME CHANGED 2013-03-22 BERGMAN, LAWRENCE R, Dr. No data
CHANGE OF PRINCIPAL ADDRESS 2002-01-24 10115 W FOREST HILL BLVD, STE 303, WELLINGTON, FL 33414 No data
CHANGE OF MAILING ADDRESS 2002-01-24 10115 W FOREST HILL BLVD, STE 303, WELLINGTON, FL 33414 No data
REGISTERED AGENT ADDRESS CHANGED 2002-01-24 10115 WEST FOREST HILL BLVD, STE 303, WELLINGTON, FL 33414 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2015-05-07
ANNUAL REPORT 2014-01-30
ANNUAL REPORT 2013-03-22
ANNUAL REPORT 2012-01-05
ANNUAL REPORT 2011-03-01
ANNUAL REPORT 2010-01-05
ANNUAL REPORT 2009-01-19
ANNUAL REPORT 2008-07-02
ANNUAL REPORT 2007-02-07
ANNUAL REPORT 2006-01-05

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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