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  5. JANET L. BLACK D.P.M., P.A.

JANET L. BLACK D.P.M., P.A. - Florida Company Profile

Company Details

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

JANET L. BLACK D.P.M., 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: 21 Dec 1999 (25 years ago)
Date of dissolution: 29 Apr 2024 (a year ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 29 Apr 2024 (a year ago)
Document Number: P99000109743
FEI/EIN Number 593614117

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 3651 LAKE CENTER DR., MT. DORA, FL, 32757
Mail Address: 3651 LAKE CENTER DR., MT. DORA, FL, 32757
ZIP code: 32757
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1891844270 2007-01-09 2015-06-25 3651 LAKE CENTER DR, MOUNT DORA, FL, 327572364, US 3651 LAKE CENTER DR, MOUNT DORA, FL, 327572364, US

Contacts
Phone +1 352-385-9156
Fax 3523859159

Authorized person
Name JANET L BLACK
Role OWNER
Phone 3523859156

Taxonomy
Taxonomy Code 213EP1101X - Primary Podiatric Medicine Podiatrist
Is Primary Yes

Other Provider Identifiers
Issuer RAILROAD MEDICARE
Number DF7049
State FL
Issuer MEDICARE
Number 1891844270
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JANET L. BLACK, D.P.M., P.A., 401(K) PLAN 2013 593614117 2014-10-10 JANET L. BLACK, D.P.M., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing JANET L. BLACK
Valid signature Filed with authorized/valid electronic signature
JANET L. BLACK, D.P.M., P.A., 401(K) PLAN 2012 593614117 2013-04-23 JANET L. BLACK, D.P.M., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2013-04-23
Name of individual signing JANET L. BLACK
Valid signature Filed with authorized/valid electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2011 593614117 2012-05-30 JANET L. BLACK, D.P.M., P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-05-30
Name of individual signing JANET L. BLACK
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2012-05-30
Name of individual signing JANET L BLACK
Valid signature Filed with incorrect/unrecognized electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2011 593614117 2012-06-25 JANET L. BLACK, D.P.M., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-06-25
Name of individual signing JANET L. BLACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-25
Name of individual signing JANET L BLACK
Valid signature Filed with authorized/valid electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2010 593614117 2012-03-16 JANET L. BLACK, D.P.M., P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-01-18
Name of individual signing JANET L BLACK
Valid signature Filed with incorrect/unrecognized electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2010 593614117 2012-02-16 JANET L. BLACK, D.P.M., P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-01-18
Name of individual signing JANET L BLACK
Valid signature Filed with incorrect/unrecognized electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2010 593614117 2012-03-21 JANET L. BLACK, D.P.M., P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-01-18
Name of individual signing JANET L BLACK
Valid signature Filed with incorrect/unrecognized electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2010 593614117 2012-02-22 JANET L. BLACK, D.P.M., P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-01-18
Name of individual signing JANET L BLACK
Valid signature Filed with incorrect/unrecognized electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2010 593614117 2012-03-21 JANET L. BLACK, D.P.M., P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-03-21
Name of individual signing JANET L BLACK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-21
Name of individual signing JANET L BLACK
Valid signature Filed with authorized/valid electronic signature
JANET L. BLACK, D.P.M., P.A. 401(K) PSP 2010 593614117 2012-02-16 JANET L. BLACK, D.P.M., P.A. 3
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 3523859156
Plan sponsor’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364

Plan administrator’s name and address
Administrator’s EIN 593614117
Plan administrator’s name JANET L. BLACK, D.P.M., P.A.
Plan administrator’s address 3651 LAKE CENTER DRIVE, MOUNT DORA, FL, 327572364
Administrator’s telephone number 3523859156

Signature of
Role Plan administrator
Date 2012-01-18
Name of individual signing JANET L BLACK
Valid signature Filed with incorrect/unrecognized electronic signature

Key Officers & Management

Name Role Address
BLACK JANET L President 3651 Lake Center Dr, Mount Dora, FL, 32757
BLACK JANET L Secretary 3651 Lake Center Dr, Mount Dora, FL, 32757
BLACK JANET L Treasurer 3651 Lake Center Dr, Mount Dora, FL, 32757
BLACK JANET L Director 3651 Lake Center Dr, Mount Dora, FL, 32757
BLACK JANET L Agent 3651 LAKE CENTER DR., MT. DORA, FL, 32757

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G07170900077 MOUNT DORA PODIATRY ACTIVE 2007-06-15 2027-12-31 - 3651 LAKE CENTER DR., MOUNT DORA, FL, 32757

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2024-04-29 - -
REGISTERED AGENT NAME CHANGED 2023-01-21 BLACK, JANET L -
REGISTERED AGENT ADDRESS CHANGED 2013-04-30 3651 LAKE CENTER DR., MT. DORA, FL 32757 -
CHANGE OF PRINCIPAL ADDRESS 2007-10-05 3651 LAKE CENTER DR., MT. DORA, FL 32757 -
CHANGE OF MAILING ADDRESS 2007-10-05 3651 LAKE CENTER DR., MT. DORA, FL 32757 -

Documents

Name Date
VOLUNTARY DISSOLUTION 2024-04-29
ANNUAL REPORT 2023-01-21
ANNUAL REPORT 2022-04-11
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-01-15
ANNUAL REPORT 2019-04-30
ANNUAL REPORT 2018-01-19
ANNUAL REPORT 2017-01-09
ANNUAL REPORT 2016-04-15
ANNUAL REPORT 2015-04-09

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5654898709 2021-04-02 0491 PPS 3651 Lake Center Dr, Mount Dora, FL, 32757-2364
Loan Status Date 2021-10-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 42152.5
Loan Approval Amount (current) 42152.5
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17736
Servicing Lender Name United Southern Bank
Servicing Lender Address 750 N Central Ave, UMATILLA, FL, 32784-8635
Rural or Urban Indicator U
Hubzone N
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Mount Dora, LAKE, FL, 32757-2364
Project Congressional District FL-06
Number of Employees 6
NAICS code 621391
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 17736
Originating Lender Name United Southern Bank
Originating Lender Address UMATILLA, FL
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 42346.87
Forgiveness Paid Date 2021-09-22

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Companies related by address

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

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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