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ROGER C. ROQUE, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: ROGER C. ROQUE, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 04 Aug 2006 (19 years ago)
Date of dissolution: 12 Apr 2022 (3 years ago)
Last Event: CONVERSION
Event Date Filed: 12 Apr 2022 (3 years ago)
Document Number: P06000102328
FEI/EIN Number 205321608
Address: 620 S LAKE ST . SUITE 2, LEESBURG, FL, 34748, US
Mail Address: 620 S LAKE ST . SUITE 2, LEESBURG, FL, 34748, US
ZIP code: 34748
City: Leesburg
County: Lake
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
ROQUE ROGER C Director 620 S LAKE ST SUITE 2, LEESBURG, FL, 34748
Wagner David Secretary 700 West Main St, Leesburg, FL, 34748
Wagner David P Agent 700 West Main St, Leesburg, FL, 34748

National Provider Identifier

NPI Number:
1932215043

Authorized Person:

Name:
ROGER CAGANDAHAN ROQUE
Role:
FAMILY PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3523573130

Form 5500 Series

Employer Identification Number (EIN):
205321608
Plan Year:
2023
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
8
Sponsors Telephone Number:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000008184 ST. FRANCIS PRIMARY CARE CLINIC EXPIRED 2012-01-24 2017-12-31 - 720 NORTH BAY STREET, SUITE 8, EUSTIS, FL, 32726

Events

Event Type Filed Date Value Description
CONVERSION 2022-04-12 - CONVERSION MEMBER. RESULTING CORPORATION WAS L22000187858. CONVERSION NUMBER 300000226313
REGISTERED AGENT ADDRESS CHANGED 2022-04-07 700 West Main St, Leesburg, FL 34748 -
REGISTERED AGENT NAME CHANGED 2022-04-07 Wagner, David P -
CHANGE OF PRINCIPAL ADDRESS 2017-01-11 620 S LAKE ST . SUITE 2, LEESBURG, FL 34748 -
CHANGE OF MAILING ADDRESS 2017-01-11 620 S LAKE ST . SUITE 2, LEESBURG, FL 34748 -
AMENDMENT 2014-05-08 - -
AMENDMENT 2014-03-31 - -
AMENDMENT 2010-08-16 - -

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J18000689141 LAPSED 2016 CA 002161 LAKE COUNTY CIRCUIT COURT 2018-09-27 2023-10-18 $144,953.58 FIRST GREEN BANK, 18251 US HIGHWAY 441, MOUNT DORA, FL, 32757

Documents

Name Date
AMENDED ANNUAL REPORT 2022-04-07
ANNUAL REPORT 2022-03-16
ANNUAL REPORT 2021-02-03
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-02-12
ANNUAL REPORT 2018-01-29
ANNUAL REPORT 2017-01-11
ANNUAL REPORT 2016-01-19
ANNUAL REPORT 2015-01-12
Amendment 2014-05-08

USAspending Awards / Financial Assistance

Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
94842.00
Total Face Value Of Loan:
94842.00
Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
94842.00
Total Face Value Of Loan:
94842.00

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$94,842
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$94,842
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$95,854.07
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $94,842

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Date of last update: 03 Aug 2025

Sources: Florida Department of State