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  5. COATOAM PERIODONTAL ASSOCIATES, PLLC

COATOAM PERIODONTAL ASSOCIATES, PLLC

Company Details

Entity Name: COATOAM PERIODONTAL ASSOCIATES, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 31 May 2006 (19 years ago)
Date of dissolution: 28 Sep 2018 (6 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 28 Sep 2018 (6 years ago)
Document Number: L06000056082
FEI/EIN Number 204989034
Address: 195 W HIGHLAND ST, ALTAMONTE SPRINGS, FL, 32714
Mail Address: 195 W HIGHLAND ST, ALTAMONTE SPRINGS, FL, 32714
ZIP code: 32714
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1386839439 2007-09-12 2007-09-12 195 W HIGHLAND ST, ALTAMONTE SPRINGS, FL, 327142599, US 195 W HIGHLAND ST, ALTAMONTE SPRINGS, FL, 327142599, US

Contacts
Phone +1 407-865-6363
Fax 4078655957

Authorized person
Name MS. SHARON COATOAM
Role OFFICE MANAGER
Phone 4078656363

Taxonomy
Taxonomy Code 1223P0300X - Periodontist
License Number DN00813
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2017 204989034 2018-08-28 COATOAM PERIODONTAL ASSOCIATES, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2018-08-28
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-08-28
Name of individual signing GARY COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2017 204989034 2018-06-25 COATOAM PERIODONTAL ASSOCIATES, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2018-06-25
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-25
Name of individual signing GARY COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2016 204989034 2017-08-01 COATOAM PERIODONTAL ASSOCIATES, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2017-08-01
Name of individual signing GARY COATOAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-08-01
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2015 204989034 2016-07-18 COATOAM PERIODONTAL ASSOCIATES, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2016-07-18
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-18
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2014 204989034 2015-08-24 COATOAM PERIODONTAL ASSOCIATES, PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078656363
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2015-08-24
Name of individual signing SHARON COAATOAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-08-24
Name of individual signing GARY COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2014 204989034 2015-08-24 COATOAM PERIODONTAL ASSOCIATES, PLLC 17
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078656363
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2015-08-24
Name of individual signing SHARON COAATOAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-08-24
Name of individual signing GARY COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401(K) PLAN 2013 204989034 2014-09-09 COATOAM PERIODONTAL ASSOCIATES, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2014-09-09
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401K PLAN 2012 204989034 2013-07-15 COATOAM PERIODONTAL ASSOCIATES, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078656363
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Signature of
Role Plan administrator
Date 2013-07-15
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401K PLAN 2011 204989034 2012-10-08 COATOAM PERIODONTAL ASSOCIATES, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Plan administrator’s name and address
Administrator’s EIN 204989034
Plan administrator’s name COATOAM PERIODONTAL ASSOCIATES, PLLC
Plan administrator’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714
Administrator’s telephone number 4078655430

Signature of
Role Plan administrator
Date 2012-10-08
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature
COATOAM PERIODONTAL ASSOC. 401K PLAN 2010 204989034 2011-10-20 COATOAM PERIODONTAL ASSOCIATES, PLLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621210
Sponsor’s telephone number 4078655430
Plan sponsor’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714

Plan administrator’s name and address
Administrator’s EIN 204989034
Plan administrator’s name COATOAM PERIODONTAL ASSOCIATES, PLLC
Plan administrator’s address 195 WEST HIGHLAND ST., ALTAMONTE SPRINGS, FL, 32714
Administrator’s telephone number 4078655430

Signature of
Role Plan administrator
Date 2011-10-20
Name of individual signing SHARON COATOAM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
COATOAM GARY W Agent 195 W HIGHLAND STREET, ALTAMONTE SPRINGS, FL, 32714

President

Name Role Address
COATOAM GARY W President 3122 TALA LOOP, LONGWOOD, FL, 32779

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 No data No data
REGISTERED AGENT NAME CHANGED 2010-04-05 COATOAM, GARY W No data
REGISTERED AGENT ADDRESS CHANGED 2010-04-05 195 W HIGHLAND STREET, ALTAMONTE SPRINGS, FL 32714 No data
CHANGE OF PRINCIPAL ADDRESS 2008-03-31 195 W HIGHLAND ST, ALTAMONTE SPRINGS, FL 32714 No data
CHANGE OF MAILING ADDRESS 2008-03-31 195 W HIGHLAND ST, ALTAMONTE SPRINGS, FL 32714 No data
LC ARTICLE OF CORRECTION 2006-06-23 No data No data

Documents

Name Date
ANNUAL REPORT 2017-05-15
ANNUAL REPORT 2016-04-20
ANNUAL REPORT 2015-04-22
ANNUAL REPORT 2014-04-21
ANNUAL REPORT 2013-04-23
ANNUAL REPORT 2012-04-10
ANNUAL REPORT 2011-04-06
ANNUAL REPORT 2010-04-05
ANNUAL REPORT 2009-04-27
ANNUAL REPORT 2008-03-31

Related by officers

COATOAM GARY W

GARY & SHARON PROPERTY HOLDINGS, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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