| Entity Name: | GATEWAY ORAL SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Nov 2021 (3 years ago) |
| Document Number: | L21000502343 |
| FEI/EIN Number | 87-3796046 |
| Mail Address: | P.O. BOX 1185, PONTE VEDRA BEACH, FL, 32004, US |
| Address: | 180 CAPULET DR, SUITE #3, ST. AUGUSTINE, FL, 32092, US |
| ZIP code: | 32092 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073336483 | 2024-11-04 | 2024-11-04 | 180 CAPULET DR STE 3, SAINT AUGUSTINE, FL, 320924541, US | 180 CAPULET DR STE 3, SAINT AUGUSTINE, FL, 320924541, US | |||||||||||||||
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| Phone | +1 904-299-2942 |
| Fax | 9042992943 |
Authorized person
| Name | DR. ROGER MYERS |
| Role | OWNER |
| Phone | 9042004375 |
Taxonomy
| Taxonomy Code | 261QD0000X - Dental Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GATEWAY ORAL SURGERY 401 PLAN | 2023 | 873779014 | 2024-10-07 | GATEWAY ORAL SURGERY | 5 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-06 |
| Name of individual signing | CHRISTINA MYERS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2013-08-15 |
| Business code | 621399 |
| Sponsor’s telephone number | 9042992942 |
| Plan sponsor’s address | 180 CAPULET DR #3, ST AUGUSTINE, FL, 32092 |
| Name | Role | Address |
|---|---|---|
| MYERS ROGER L | Agent | 180 CAPULET DR., ST. AUGUSTINE, FL, 32092 |
| Name | Role | Address |
|---|---|---|
| MYERS ROGER L | Manager | P.O. BOX 1185, PONTE VEDRA BEACH, FL, 32004 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-03-23 |
| Florida Limited Liability | 2021-11-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
