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  5. JOHN J. GREEN, D.O., P.A.

JOHN J. GREEN, D.O., P.A.

Company Details

Entity Name: JOHN J. GREEN, D.O., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 26 Sep 2003 (21 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 13 Apr 2020 (5 years ago)
Document Number: P03000106202
FEI/EIN Number 161685509
Address: 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912
Mail Address: 14131 Metropolis Avenue, FT MYERS, FL, 33912, US
ZIP code: 33912
County: Lee
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2019 161685509 2020-08-26 JOHN J. GREEN, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2020-08-26
Name of individual signing JOHN J GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-08-26
Name of individual signing JOHN J GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2018 161685509 2019-04-26 JOHN J. GREEN, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2019-04-26
Name of individual signing JOHN J. GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-26
Name of individual signing JOHN J. GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2017 161685509 2018-06-02 JOHN J. GREEN, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2018-06-02
Name of individual signing JOHN J. GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-02
Name of individual signing JOHN J. GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2016 161685509 2017-07-10 JOHN J. GREEN, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2017-07-10
Name of individual signing JOHN J. GREEM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-10
Name of individual signing JOHN J. GREEM
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2015 161685509 2016-04-11 JOHN J. GREEN, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2016-04-11
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-04-11
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2014 161685509 2015-08-26 JOHN J. GREEN, D.O., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2015-08-26
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-08-26
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2013 161685509 2014-07-08 JOHN J. GREEN, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2014-07-08
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-08
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2012 161685509 2013-04-17 JOHN J. GREEN, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2013-04-17
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-17
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2011 161685509 2012-07-13 JOHN J. GREEN, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Plan administrator’s name and address
Administrator’s EIN 161685509
Plan administrator’s name JOHN J. GREEN, D.O., P.A.
Plan administrator’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912
Administrator’s telephone number 2393324099

Signature of
Role Plan administrator
Date 2012-07-13
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-13
Name of individual signing JOHN GREEN
Valid signature Filed with authorized/valid electronic signature
JOHN J. GREEN, D.O., P.A., 401(K) PROFIT SHARING PLAN 2010 161685509 2011-09-13 JOHN J. GREEN, D.O., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2393324099
Plan sponsor’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912

Plan administrator’s name and address
Administrator’s EIN 161685509
Plan administrator’s name JOHN J. GREEN, D.O., P.A.
Plan administrator’s address 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL, 33912
Administrator’s telephone number 2393324099

Signature of
Role Plan administrator
Date 2011-09-13
Name of individual signing JOHN J. GREEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-13
Name of individual signing JOHN J. GREEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GREEN JOHN JDO Agent 16966 COLONY LAKES BLVD, FT MYERS, FL, 33908

Director

Name Role Address
GREEN JOHN JDO Director 16966 COLONY LAKES BLVD, FT MYERS, FL, 33908

Events

Event Type Filed Date Value Description
REINSTATEMENT 2020-04-13 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 No data No data
CHANGE OF MAILING ADDRESS 2017-01-10 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL 33912 No data
REGISTERED AGENT NAME CHANGED 2013-01-24 GREEN, JOHN J, DO No data
CHANGE OF PRINCIPAL ADDRESS 2009-02-22 14131 METROPOLIS AVENUE, SUITE 104, FORT MYERS, FL 33912 No data

Documents

Name Date
ANNUAL REPORT 2024-02-07
ANNUAL REPORT 2023-03-01
ANNUAL REPORT 2022-02-10
ANNUAL REPORT 2021-02-03
REINSTATEMENT 2020-04-13
ANNUAL REPORT 2018-01-13
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-03-02
ANNUAL REPORT 2015-01-09
ANNUAL REPORT 2014-01-10

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Related by address

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Date of last update: 01 Feb 2025

Sources: Florida Department of State

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