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  5. JOHNNY GURGEN, D.O., P.A.

JOHNNY GURGEN, D.O., P.A.

Company Details

Entity Name: JOHNNY GURGEN, D.O., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 14 Nov 2011 (13 years ago)
Document Number: P11000098517
FEI/EIN Number 453825600
Address: 1340 CITIZENS BLVD, LEESBURG, FL, 34748, US
Mail Address: 1340 CITIZENS BLVD, LEESBURG, FL, 34748, US
ZIP code: 34748
County: Lake
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOHNNY GURGEN, D. O. , P. A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2023 453825600 2024-09-17 JOHNNY GURGEN, D.O., P.A. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Sponsor’s telephone number 3524357695
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 1340 CITIZENS BLVD, LEESBURG, FL, 34748
JOHNNY GURGEN, D. O. , P. A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2022 453825600 2023-11-29 JOHNNY GURGEN, D.O., P.A. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Sponsor’s telephone number 3524357695
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 1340 CITIZENS BLVD, LEESBURG, FL, 34748
JOHNNY GURGEN, D. O. , P. A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2021 453825600 2022-10-06 JOHNNY GURGEN, D.O., P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Sponsor’s telephone number 3524357695
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 1340 CITIZENS BLVD, LEESBURG, FL, 34748
JOHNNY GURGEN, D. O. , P. A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2020 453825600 2021-10-05 JOHNNY GURGEN, D.O., P.A. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Sponsor’s telephone number 3524357695
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 1340 CITIZENS BLVD, LEESBURG, FL, 34748
JOHNNY GURGEN, D. O. , P. A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2019 453825600 2020-06-19 JOHNNY GURGEN, D.O., P.A. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Sponsor’s telephone number 3524357695
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 1340 CITIZENS BLVD, LEESBURG, FL, 34748
JOHNNY GURGEN, D. O. , P. A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2018 453825600 2019-07-23 JOHNNY GURGEN, D.O., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 920 ROLLING ACRES RD., SUITE 203, LADY LAKE, FL, 32159
JOHNNY GURGEN, D.O., P.A. D/B/A LEESBURG DERMATOLOGY & MOHS SURGERY RETIREMENT TRUST 2014 453825600 2015-07-06 JOHNNY GURGEN, D.O., P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 541600
Sponsor’s telephone number 3524357695
Plan sponsor’s DBA name LEESBURG DERMATOLOGY & MOHS SURGERY
Plan sponsor’s address 210 S LAKE DT, STE #9, LEESBURG, FL, 34748

Signature of
Role Plan administrator
Date 2015-07-06
Name of individual signing JOHNNY GURGEN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-06
Name of individual signing JOHNNY GURGEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
GURGEN JOHNNY Agent 20716 Sugarloaf Mountain Road, Clermont, FL, 34715

Director

Name Role Address
GURGEN JOHNNY Director 1340 CITIZENS BLVD, LEESBURG, FL, 34748

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000043384 LADY LAKE DERMATOLOGY & MOHS SURGERY ACTIVE 2014-05-01 2029-12-31 No data 1340 CITIZENS BLVD, LEESBURG, FL, 34748
G12000036868 LEESBURG DERMATOLOGY & MOHS SURGERY ACTIVE 2012-04-18 2027-12-31 No data 920 ROLLING ACRES RD, SUITE 205, LADY LAKE, FL, 32159

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2019-02-07 20716 Sugarloaf Mountain Road, Clermont, FL 34715 No data
CHANGE OF PRINCIPAL ADDRESS 2018-01-31 1340 CITIZENS BLVD, LEESBURG, FL 34748 No data
CHANGE OF MAILING ADDRESS 2018-01-31 1340 CITIZENS BLVD, LEESBURG, FL 34748 No data

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-01-25
ANNUAL REPORT 2022-02-11
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-02-07
ANNUAL REPORT 2018-01-31
ANNUAL REPORT 2017-03-05
ANNUAL REPORT 2016-04-25
ANNUAL REPORT 2015-02-18

Related by officers

GURGEN JOHNNY

GURGEN PROPERTIES, LLC GURGEN INVESTMENTS, LLC GURGEN CHARTERS LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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