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  5. JERRI L. JOHNSON, M.D., P.A.

JERRI L. JOHNSON, M.D., P.A. - Florida Company Profile

Company Details

Entity Name: JERRI L. JOHNSON, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

JERRI L. JOHNSON, M.D., P.A. 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: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 29 Mar 1993 (32 years ago)
Date of dissolution: 11 Nov 2023 (a year ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 11 Nov 2023 (a year ago)
Document Number: P93000024152
FEI/EIN Number 593172185

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 702 Gladwin Ave, Fern Park, FL, 32730, US
Mail Address: 702 Gladwin Ave, Fern Park, FL, 32730, US
ZIP code: 32730
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1588856231 2007-08-16 2007-08-16 411 MAITLAND AVE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448, US 411 MAITLAND AVE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448, US

Contacts
Phone +1 407-260-2606
Fax 4072606339

Authorized person
Name AMY KEENEY
Role OFFICE MANAGER
Phone 4072602606

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME0049721
State FL
Is Primary Yes

Other Provider Identifiers
Issuer NPI TYPE I
Number 1588648265
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2023 593172185 2024-04-02 JERRI L. JOHNSON, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 702 GLADWIN AVENUE, FERN PARK, FL, 327302004
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2022 593172185 2023-05-08 JERRI L. JOHNSON, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 702 GLADWIN AVENUE, FERN PARK, FL, 327302004
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2021 593172185 2022-09-09 JERRI L. JOHNSON, M.D., P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2020 593172185 2021-08-23 JERRI L. JOHNSON, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2019 593172185 2020-09-18 JERRI L. JOHNSON, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2018 593172185 2019-06-27 JERRI L. JOHNSON, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2017 593172185 2018-08-30 JERRI L. JOHNSON, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2016 593172185 2017-08-23 JERRI L. JOHNSON, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448

Signature of
Role Plan administrator
Date 2017-08-23
Name of individual signing JERRI L. JOHNSON, M.D.
Valid signature Filed with authorized/valid electronic signature
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2015 593172185 2016-09-21 JERRI L. JOHNSON, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448

Signature of
Role Plan administrator
Date 2016-09-21
Name of individual signing JERRI L. JOHNSON, M.D.
Valid signature Filed with authorized/valid electronic signature
401K/PROFIT SHARING PLAN AND TRUST FOR EMPLOYEES OF JERRI L. JOHNSON, M.D., P.A. 2014 593172185 2015-06-16 JERRI L. JOHNSON, M.D., P.A. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 4075995900
Plan sponsor’s address 411 MAITLAND AVENUE, SUITE 1001, ALTAMONTE SPRINGS, FL, 327015448

Signature of
Role Plan administrator
Date 2015-06-16
Name of individual signing JERRI L. JOHNSON, M.D.
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
JOHNSON JERRI LMD President 702 Gladwin Ave, Fern Park, FL, 32730
JOHNSON JERRI LMD Agent 702 Gladwin Ave, Fern Park, FL, 32730

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000055438 ALTAMONTE DERMATOLOGY EXPIRED 2013-06-06 2018-12-31 - 411 MAITLAND AVE, SUITE 1001, ALTAMONTE SPRINGS, FL, 32701

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2023-11-11 - -
CHANGE OF PRINCIPAL ADDRESS 2023-01-09 702 Gladwin Ave, Fern Park, FL 32730 -
CHANGE OF MAILING ADDRESS 2023-01-09 702 Gladwin Ave, Fern Park, FL 32730 -
REGISTERED AGENT ADDRESS CHANGED 2023-01-09 702 Gladwin Ave, Fern Park, FL 32730 -
REGISTERED AGENT NAME CHANGED 2013-01-07 JOHNSON, JERRI L, MD -

Documents

Name Date
VOLUNTARY DISSOLUTION 2023-11-11
ANNUAL REPORT 2023-01-09
ANNUAL REPORT 2022-01-23
ANNUAL REPORT 2021-01-09
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-01-27
ANNUAL REPORT 2018-01-08
ANNUAL REPORT 2017-01-10
ANNUAL REPORT 2016-03-26
ANNUAL REPORT 2015-01-07

Companies related by officers

No other companies in our directory share the same officers as JERRI L. JOHNSON, M.D., P.A.

Companies related by address

No other companies in our directory share the same address as JERRI L. JOHNSON, M.D., P.A.

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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