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  5. ALLIANT DERMATOLOGY PA

ALLIANT DERMATOLOGY PA - Florida Company Profile

Company Details

Entity Name: ALLIANT DERMATOLOGY PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

ALLIANT DERMATOLOGY PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 05 Jul 2012 (13 years ago)
Last Event: AMENDMENT
Event Date Filed: 13 Oct 2016 (9 years ago)
Document Number: P12000059368
FEI/EIN Number 455622044

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162, US
Mail Address: 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162, US
ZIP code: 32162
County: Sumter
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1619232501 2012-07-07 2022-07-21 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 321623670, US 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 321623670, US

Contacts
Phone +1 352-399-7295
Fax 3523997294

Authorized person
Name DR. DAVID JOHN CASPER
Role CEO AND PHYSICIAN
Phone 4078839946

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number ME 108772
State FL
Is Primary Yes
Taxonomy Code 207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary No
Taxonomy Code 207ND0900X - Dermatopathology Physician
Is Primary No

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number QPF7T
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALLIANT DERMATOLOGY 401(K) PLAN 2023 455622044 2024-02-16 ALLIANT DERMATOLOGY PA 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 5132633602
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670
ALLIANT DERMATOLOGY 401(K) PLAN 2022 455622044 2023-07-19 ALLIANT DERMATOLOGY PA 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 5132633602
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670
ALLIANT DERMATOLOGY 401(K) PLAN 2021 455622044 2022-09-20 ALLIANT DERMATOLOGY PA 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 5132633602
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670
ALLIANT DERMATOLOGY 401(K) PLAN 2020 455622044 2021-07-13 ALLIANT DERMATOLOGY PA 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 5132633602
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670
ALLIANT DERMATOLOGY 401(K) PLAN 2019 455622044 2020-08-20 ALLIANT DERMATOLOGY PA 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 5132633602
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670
ALLIANT DERMATOLOGY 401(K) PLAN 2018 455622044 2019-10-14 ALLIANT DERMATOLOGY PA 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 5132633602
Plan sponsor’s address 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 321623670

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing DAVID W MOUNTFORD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-10-14
Name of individual signing DAVID W MOUNTFORD
Valid signature Filed with authorized/valid electronic signature
ALLIANT DERMATOLOGY 401(K) PLAN 2017 455622044 2018-10-03 ALLIANT DERMATOLOGY PA 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 3523997295
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing LAURA CASPER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-03
Name of individual signing LAURA CASPER
Valid signature Filed with authorized/valid electronic signature
ALLIANT DERMATOLOGY 401(K) PLAN 2016 455622044 2017-07-11 ALLIANT DERMATOLOGY PA 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 3523997295
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670

Signature of
Role Plan administrator
Date 2017-07-11
Name of individual signing LAURA CASPER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-11
Name of individual signing LAURA CASPER
Valid signature Filed with authorized/valid electronic signature
ALLIANT DERMATOLOGY 401(K) PLAN 2015 455622044 2016-07-11 ALLIANT DERMATOLOGY PA 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 3523997295
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670

Signature of
Role Plan administrator
Date 2016-07-11
Name of individual signing DAVID CASPER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-11
Name of individual signing DAVID CASPER
Valid signature Filed with authorized/valid electronic signature
ALLIANT DERMATOLOGY 401(K) PLAN 2014 455622044 2015-04-08 ALLIANT DERMATOLOGY PA 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-10-01
Business code 621399
Sponsor’s telephone number 3523997295
Plan sponsor’s address 8620A EAST COUNTY ROAD 466, THE VILLAGES, FL, 321623670

Signature of
Role Plan administrator
Date 2015-04-08
Name of individual signing STEVEN CASPER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-08
Name of individual signing STEVEN CASPER
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
CASPER DAVID J Chief Executive Officer 8620A E COUNTY ROAD 466, THE VILLAGES, FL, 32162
CASPER David Agent 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2019-03-03 8620 E COUNTY ROAD 466, THE VILLAGES, FL 32162 -
CHANGE OF MAILING ADDRESS 2019-03-03 8620 E COUNTY ROAD 466, THE VILLAGES, FL 32162 -
AMENDMENT 2016-10-13 - -
REGISTERED AGENT NAME CHANGED 2016-10-13 CASPER, David -
REGISTERED AGENT ADDRESS CHANGED 2016-10-13 8620 E COUNTY ROAD 466, THE VILLAGES, FL 32162 -
AMENDMENT 2012-12-26 - -

Documents

Name Date
ANNUAL REPORT 2024-03-12
ANNUAL REPORT 2023-03-17
ANNUAL REPORT 2022-01-30
ANNUAL REPORT 2021-02-26
ANNUAL REPORT 2020-02-27
ANNUAL REPORT 2019-03-03
ANNUAL REPORT 2018-04-01
ANNUAL REPORT 2017-01-28
Amendment 2016-10-13
ANNUAL REPORT 2016-03-06

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6577507102 2020-04-14 0491 PPP 8620 East County Road 466, The Villages, FL, 32162
Loan Status Date 2021-02-23
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 543400
Loan Approval Amount (current) 543400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 121536
Servicing Lender Name Customers Bank
Servicing Lender Address 40 General Warren Blvd, Malvern, PA, 19355
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address The Villages, SUMTER, FL, 32162-0001
Project Congressional District FL-06
Number of Employees 60
NAICS code 453998
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 499141
Originating Lender Name Readycap Lending, LLC
Originating Lender Address BERKELEY HEIGHTS, NJ
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 546943.27
Forgiveness Paid Date 2020-12-31

Companies related by officers

CASPER David

EGG & I OCALA, LLC - Inactive
Florida Limited Liability Co. (2014 - 2017)
ALLIANT MANAGEMENT GROUP, INC. - Inactive
Domestic Profit (2012 - 2022)

Companies related by address

8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162, US

CREEKSIDE DERMATOLOGY, PA

8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162, US

CREEKSIDE DERMATOLOGY, PA

Date of last update: 03 Apr 2025

Sources: Florida Department of State

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