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  5. ALLEN R. CASTELLO, MD, LLC

ALLEN R. CASTELLO, MD, LLC

Company Details

Entity Name: ALLEN R. CASTELLO, MD, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 17 Sep 2008 (16 years ago)
Date of dissolution: 27 Sep 2019 (5 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2019 (5 years ago)
Document Number: L08000088325
FEI/EIN Number 263378750
Address: 1205 HWY 2, WESTVILLE, FL, 32464, US
Mail Address: 1205 HWY 2, WESTVILLE, FL, 32464, US
ZIP code: 32464
County: Holmes
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326286345 2009-01-29 2009-01-29 1173 BLACKWOOD AVE, OCOEE, FL, 347614518, US 1173 BLACKWOOD AVE, OCOEE, FL, 347614518, US

Contacts
Phone +1 407-877-4458
Fax 4078774494

Authorized person
Name MS. TRACY B KIAH PECK
Role BILLING MANAGER
Phone 4078774458

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number ME56679
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number 10227
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2015 263378750 2016-10-19 ALLEN R. CASTELLO, MD LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Signature of
Role Plan administrator
Date 2016-10-19
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-19
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2015 263378750 2016-03-25 ALLEN R. CASTELLO, MD LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Signature of
Role Plan administrator
Date 2016-03-25
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-03-25
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2014 263378750 2015-02-28 ALLEN R. CASTELLO, MD LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Signature of
Role Plan administrator
Date 2015-02-28
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-02-28
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2013 263378750 2014-02-16 ALLEN R. CASTELLO, MD LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Signature of
Role Plan administrator
Date 2014-02-16
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-02-16
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2012 263378750 2013-03-18 ALLEN R. CASTELLO, MD LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Signature of
Role Plan administrator
Date 2013-03-18
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-18
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2011 263378750 2012-02-11 ALLEN R. CASTELLO, MD LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Plan administrator’s name and address
Administrator’s EIN 263378750
Plan administrator’s name ALLEN R. CASTELLO, MD LLC
Plan administrator’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518
Administrator’s telephone number 4078774458

Signature of
Role Plan administrator
Date 2012-02-11
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-02-11
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2010 263378750 2011-02-02 ALLEN R. CASTELLO, MD LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Plan administrator’s name and address
Administrator’s EIN 263378750
Plan administrator’s name ALLEN R. CASTELLO, MD LLC
Plan administrator’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518
Administrator’s telephone number 4078774458

Signature of
Role Plan administrator
Date 2011-02-02
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-02-02
Name of individual signing ALLEN CASTELLO
Valid signature Filed with authorized/valid electronic signature
ALLEN R. CASTELLO, MD LLC 401(K) PLAN 2009 263378750 2010-04-20 ALLEN R. CASTELLO, MD LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 4078774458
Plan sponsor’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518

Plan administrator’s name and address
Administrator’s EIN 263378750
Plan administrator’s name ALLEN R. CASTELLO, MD LLC
Plan administrator’s address 1173 BLACKWOOD AVE, OCOEE, FL, 347614518
Administrator’s telephone number 4078774458

Signature of
Role Plan administrator
Date 2010-04-16
Name of individual signing ALLEN R. CASTELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-04-16
Name of individual signing ALLEN R. CASTELLO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CASTELLO ALLEN RDr. Agent 1205 HWY 2, WESTVILLE, FL, 32464

Manager

Name Role Address
CASTELLO ALLEN RDr. Manager 1205 HWY 2, WESTVILLE, FL, 32464

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 No data No data
REGISTERED AGENT ADDRESS CHANGED 2018-02-15 1205 HWY 2, WESTVILLE, FL 32464 No data
CHANGE OF PRINCIPAL ADDRESS 2018-01-30 1205 HWY 2, WESTVILLE, FL 32464 No data
CHANGE OF MAILING ADDRESS 2018-01-30 1205 HWY 2, WESTVILLE, FL 32464 No data
REGISTERED AGENT NAME CHANGED 2015-01-11 CASTELLO, ALLEN R, Dr. No data
LC AMENDMENT 2009-01-05 No data No data

Documents

Name Date
ANNUAL REPORT 2018-02-15
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-01-07
ANNUAL REPORT 2015-01-11
ANNUAL REPORT 2014-01-09
ANNUAL REPORT 2013-01-25
ANNUAL REPORT 2012-01-22
ANNUAL REPORT 2011-01-08
ANNUAL REPORT 2010-01-09
ANNUAL REPORT 2009-01-05

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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