| Entity Name: | THOMAS CARRASQUILLO, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Apr 1995 (30 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P95000027654 |
| FEI/EIN Number | 65-0570220 |
| Address: | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 |
| Mail Address: | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 |
| ZIP code: | 33990 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285717983 | 2006-10-24 | 2020-08-22 | 1435 SE 8TH TER, SUITE B, CAPE CORAL, FL, 339903289, US | 1435 SE 8TH TER, SUITE B, CAPE CORAL, FL, 339903289, US | |||||||||||||||||||
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| Phone | +1 239-458-8222 |
| Fax | 2394588220 |
Authorized person
| Name | DR. THOMAS CARRASQUILLO |
| Role | PRESIDENT |
| Phone | 2394588222 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | ME36576 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS CARRASQUILLO, M.D., P.A. EMPLOYEE PROFIT SHARING PLAN | 2010 | 650570220 | 2011-04-07 | THOMAS CARRASQUILLO, M.D., P.A. | 1 | |||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 650570220 |
| Plan administrator’s name | THOMAS CARRASQUILLO, M.D., P.A. |
| Plan administrator’s address | 3812 HIDDEN ACRES CIRCLE S, NORTH FORT MYERS, FL, 33903 |
| Administrator’s telephone number | 2394588222 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 1 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2011-04-07 |
| Name of individual signing | THOMAS CARRASQUILLO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1995-04-06 |
| Business code | 621111 |
| Sponsor’s telephone number | 2394588222 |
| Plan sponsor’s mailing address | 3812 HIDDEN ACRES CIRCLE S., N. FORT MYERS, FL, 33903 |
| Plan sponsor’s address | 3812 HIDDEN ACRES CIRCLE S., N. FORT MYERS, FL, 33903 |
Plan administrator’s name and address
| Administrator’s EIN | 650570220 |
| Plan administrator’s name | THOMAS CARRASQUILLO, M.D., P.A. |
| Plan administrator’s address | 1435 SE 8TH TERRACE #B, CAPE CORAL, FL, 33990 |
| Administrator’s telephone number | 2394588222 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 1 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-23 |
| Name of individual signing | THOMAS CARRASQUILLO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CARRASQUILLO, THOMAS | Agent | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 |
| Name | Role | Address |
|---|---|---|
| CARRASQUILLO, THOMAS | Director | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-04 | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 | No data |
| CHANGE OF MAILING ADDRESS | 2007-04-04 | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-04 | 1435 SE 8TH TERR, STE B, CAPE CORAL, FL 33990 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-03-23 |
| ANNUAL REPORT | 2008-03-25 |
| ANNUAL REPORT | 2007-04-04 |
| ANNUAL REPORT | 2006-03-31 |
| ANNUAL REPORT | 2005-04-01 |
| ANNUAL REPORT | 2004-04-26 |
| ANNUAL REPORT | 2003-04-07 |
| ANNUAL REPORT | 2002-05-06 |
| ANNUAL REPORT | 2001-04-26 |
| ANNUAL REPORT | 2000-04-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
