Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Lee
    4. ›
  4. 33905
    5. ›
  5. WALLACE FAMILY PRACTICE, P.A.

WALLACE FAMILY PRACTICE, P.A.

Company Details

Entity Name: WALLACE FAMILY PRACTICE, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 28 Sep 2006 (18 years ago)
Document Number: P06000125002
FEI/EIN Number 205630941
Address: 14651 Palm Beach Blvd, Fort Myers, FL, 33905, US
Mail Address: 14651 Palm Beach Blvd, Fort Myers, FL, 33905, US
ZIP code: 33905
County: Lee
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2023 205630941 2024-08-26 WALLACE FAMILY PRACTICE, P.A. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 14651 PALM BEACH BLVD., SUITE 100, FORT MYERS, FL, 33905
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2022 205630941 2023-05-31 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 14651 PALM BEACH BLVD., SUITE 100, FORT MYERS, FL, 33905
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2021 205630941 2022-06-08 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 14651 PALM BEACH BLVD., SUITE 100, FORT MYERS, FL, 33905
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2020 205630941 2021-06-09 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 14651 PALM BEACH BLVD., SUITE 100, FORT MYERS, FL, 33905
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2019 205630941 2020-10-08 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 3400 LEE BOULEVARD, SUITE 108, LEHIGH ACRES, FL, 33971
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2018 205630941 2019-10-11 WALLACE FAMILY PRACTICE, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 3400 LEE BOULEVARD, SUITE 108, LEHIGH ACRES, FL, 33971
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2017 205630941 2018-09-28 WALLACE FAMILY PRACTICE, P.A. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 3400 LEE BOULEVARD, SUITE 108, LEHIGH ACRES, FL, 33971
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2016 205630941 2017-10-13 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 3400 LEE BOULEVARD, SUITE 108, LEHIGH ACRES, FL, 33971
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2015 205630941 2016-07-18 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 3400 LEE BOULEVARD, SUITE 108, LEHIGH ACRES, FL, 33971

Signature of
Role Plan administrator
Date 2016-07-18
Name of individual signing TASHA B. WALLACE
Valid signature Filed with authorized/valid electronic signature
WALLACE FAMILY PRACTICE SAFE HARBOR 401(K) PLAN 2014 205630941 2015-10-12 WALLACE FAMILY PRACTICE, P.A. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-03-31
Business code 621111
Sponsor’s telephone number 2393692903
Plan sponsor’s address 3400 LEE BOULEVARD, SUITE 108, LEHIGH ACRES, FL, 33971

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing TASHA B. WALLACE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WALLACE TASHA B Agent 12011 Rosemount Dr, FORT MYERS, FL, 33913

Director

Name Role Address
WALLACE TASHA B Director 12011 Rosemount Dr, Fort Myers, FL, 33913

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-02-16 14651 Palm Beach Blvd, 100, Fort Myers, FL 33905 No data
CHANGE OF MAILING ADDRESS 2021-02-16 14651 Palm Beach Blvd, 100, Fort Myers, FL 33905 No data
REGISTERED AGENT ADDRESS CHANGED 2021-02-16 12011 Rosemount Dr, FORT MYERS, FL 33913 No data

Documents

Name Date
ANNUAL REPORT 2024-02-23
ANNUAL REPORT 2023-03-05
ANNUAL REPORT 2022-03-07
ANNUAL REPORT 2021-02-16
ANNUAL REPORT 2020-03-23
ANNUAL REPORT 2019-03-15
ANNUAL REPORT 2018-02-27
ANNUAL REPORT 2017-03-29
ANNUAL REPORT 2016-03-10
ANNUAL REPORT 2015-01-13

Related by officers

WALLACE TASHA B

WALLACE FAMILY INVESTMENT GROUP, LLC

Related by address

No related companies by address

Date of last update: 01 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