| Entity Name: | CHARLES E. LIOTT D.C., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 16 Jun 1988 (37 years ago) |
| Document Number: | M85658 |
| FEI/EIN Number | 650060273 |
| Address: | 2477 STICKNEY PT ROAD, SUITE 202A, SARASOTA, FL, 34231, US |
| Mail Address: | 2477 STICKNEY PT ROAD, SUITE 202A, SARASOTA, FL, 34231, US |
| ZIP code: | 34231 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811173230 | 2008-01-16 | 2008-05-29 | 2477 STICKNEY POINT RD, SUITE 202A, SARASOTA, FL, 342314076, US | 2477 STICKNEY POINT RD, SUITE 202A, SARASOTA, FL, 342314076, US | |||||||||||||||||||||||
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| Phone | +1 941-923-2567 |
Authorized person
| Name | CHARLES E LIOTT |
| Role | OWNER |
| Phone | 9419232567 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH3893 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS GROUP |
| Number | 45906 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARLES E. LIOTT, D.C., P.A. PROFIT SHARING PLAN AND TRUST | 2010 | 650060273 | 2010-11-30 | CHARLES E. LIOTT, D.C., P.A. | 6 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 650060273 |
| Plan administrator’s name | CHARLES E. LIOTT, D.C., P.A. |
| Plan administrator’s address | 2477 STICKNEY POINT RD, SUITE 202A, SARASOTA, FL, 34231 |
| Administrator’s telephone number | 9419232567 |
Signature of
| Role | Plan administrator |
| Date | 2010-11-30 |
| Name of individual signing | CHARLES E. LIOTT |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1994-01-01 |
| Business code | 621310 |
| Sponsor’s telephone number | 9419232567 |
| Plan sponsor’s address | 2477 STICKNEY POINT RD, SUITE 202A, SARASOTA, FL, 34231 |
Plan administrator’s name and address
| Administrator’s EIN | 650060273 |
| Plan administrator’s name | CHARLES E. LIOTT, D.C., P.A. |
| Plan administrator’s address | 2477 STICKNEY POINT RD, SUITE 202A, SARASOTA, FL, 34231 |
| Administrator’s telephone number | 9419232567 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-21 |
| Name of individual signing | CHARLES E. LIOTT |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| WATTS DANA J. A | Agent | 1620 MAIN STREET, SARASOTA, FL, 34236 |
| Name | Role | Address |
|---|---|---|
| LIOTT, CHARLES E. | President | 2477 STICKNEY PT RD 202A, SARASOTA, FL, 34231 |
| Name | Role | Address |
|---|---|---|
| LIOTT, CHARLES E. | Secretary | 2477 STICKNEY PT RD 202A, SARASOTA, FL, 34231 |
| LIOTT CATHERINE A | Secretary | 2477 STICKNEY PT ROAD, SARASOTA, FL, 34231 |
| Name | Role | Address |
|---|---|---|
| LIOTT, CHARLES E. | Treasurer | 2477 STICKNEY PT RD 202A, SARASOTA, FL, 34231 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
