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  5. NANCY R. SCHLEIDER, MD, PA

NANCY R. SCHLEIDER, MD, PA

Company Details

Entity Name: NANCY R. SCHLEIDER, MD, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 12 Jan 1998 (27 years ago)
Date of dissolution: 25 Sep 2020 (4 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2020 (4 years ago)
Document Number: P98000003549
FEI/EIN Number 650804823
Address: 6900 Daniels Pkwy, FORT MYERS, FL, 33912, US
Mail Address: 6900 Daniels Pkwy, FORT MYERS, FL, 33912, US
ZIP code: 33912
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1629191804 2007-04-10 2013-08-20 PO BOX 7518, FORT MYERS, FL, 339117518, US 13691 METRO PKWY, SUITE 420, FORT MYERS, FL, 339124327, US

Contacts
Phone +1 239-931-7262
Fax 2399317397
Phone +1 239-768-2057
Fax 2397682133

Authorized person
Name DR. NANCY SCHLEIDER
Role PRESIDENT
Phone 2397682057

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number ME46042
State FL
Is Primary Yes

Other Provider Identifiers
Issuer RAILROAD MEDICARE
Number DS8673
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2018 650804823 2019-01-26 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13261 PONDEROSA WAY, FT. MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2019-01-26
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2017 650804823 2018-05-29 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13261 PONDEROSA WAY, FT. MYERS, FL, 33907

Signature of
Role Plan administrator
Date 2018-05-28
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2016 650804823 2017-03-27 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2017-03-27
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2015 650804823 2016-05-12 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2016-05-12
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2014 650804823 2015-03-13 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2015-03-12
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2013 650804823 2014-06-19 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2014-06-19
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2012 650804823 2013-05-16 NANCY R. SCHLEIDER, MD, PA 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Signature of
Role Plan administrator
Date 2013-05-15
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2011 650804823 2012-05-30 NANCY R. SCHLEIDER, MD, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Plan administrator’s name and address
Administrator’s EIN 650804823
Plan administrator’s name NANCY R. SCHLEIDER, MD, PA
Plan administrator’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912
Administrator’s telephone number 2397682057

Signature of
Role Plan administrator
Date 2012-05-29
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2010 650804823 2011-06-16 NANCY R. SCHLEIDER, MD, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Plan administrator’s name and address
Administrator’s EIN 650804823
Plan administrator’s name NANCY R. SCHLEIDER, MD, PA
Plan administrator’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912
Administrator’s telephone number 2397682057

Signature of
Role Plan administrator
Date 2011-06-16
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature
NANCY R. SCHLEIDER, MD, PA PROFIT SHARING PLAN 2009 650804823 2010-08-10 NANCY R. SCHLEIDER, MD, PA 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621111
Sponsor’s telephone number 2397682057
Plan sponsor’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912

Plan administrator’s name and address
Administrator’s EIN 650804823
Plan administrator’s name NANCY R. SCHLEIDER, MD, PA
Plan administrator’s address 13691 METRO PARKWAY S. SUITE 420, FT. MYERS, FL, 33912
Administrator’s telephone number 2397682057

Signature of
Role Plan administrator
Date 2010-08-10
Name of individual signing NANCY SCHLEIDER-KUSHNER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KUSHNER NANCY R Agent 6900 Daniels Pkwy, FORT MYERS, FL, 33912

President

Name Role Address
KUSHNER NANCY R President 6900 Daniels Pkwy, FORT MYERS, FL, 33912

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2019-02-04 6900 Daniels Pkwy, 29-203, FORT MYERS, FL 33912 No data
CHANGE OF MAILING ADDRESS 2019-02-04 6900 Daniels Pkwy, 29-203, FORT MYERS, FL 33912 No data
REGISTERED AGENT ADDRESS CHANGED 2019-02-04 6900 Daniels Pkwy, 29-203, FORT MYERS, FL 33912 No data

Documents

Name Date
ANNUAL REPORT 2019-02-04
ANNUAL REPORT 2018-03-10
ANNUAL REPORT 2017-01-13
ANNUAL REPORT 2016-02-05
ANNUAL REPORT 2015-02-08
ANNUAL REPORT 2014-02-18
ANNUAL REPORT 2013-01-07
ANNUAL REPORT 2012-01-07
ANNUAL REPORT 2011-01-07
ANNUAL REPORT 2010-01-07

Related by officers

No related officers

Related by address

6900 Daniels Pkwy, FORT MYERS, FL, 33912, US

COAST 2 COAST ERECTORS, INC. ELEGANT INSANITY, LLC RGG DIAMOND STRAND HOLDINGS, LLC MD2F, LLC PROJECT TWO SIX INC. CORRENTI ACCOUNTING SERVICES, LLC THE TAX SHARK - FLORIDA LLC JONESEZ BBQ, INC. YELLOWSTONE PROPERTY DEVELOPERS, LLC

6900 Daniels Pkwy, FORT MYERS, FL, 33912, US

COAST 2 COAST ERECTORS, INC. ELEGANT INSANITY, LLC RGG DIAMOND STRAND HOLDINGS, LLC MD2F, LLC PROJECT TWO SIX INC. CORRENTI ACCOUNTING SERVICES, LLC THE TAX SHARK - FLORIDA LLC JONESEZ BBQ, INC. YELLOWSTONE PROPERTY DEVELOPERS, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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