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  5. SANTA ROSA GASTROENTEROLOGY INC.

SANTA ROSA GASTROENTEROLOGY INC. - Florida Company Profile

Company Details

Entity Name: SANTA ROSA GASTROENTEROLOGY INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

SANTA ROSA GASTROENTEROLOGY INC. 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: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 02 Jun 2003 (22 years ago)
Document Number: P03000060431
FEI/EIN Number 200009224

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 3117 Merion Dr, Miramar Beach, FL, 32550, US
Mail Address: 3117 MERION DR, MIRAMAR BEACH, FL, 32550, US
ZIP code: 32550
County: Walton
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1790956472 2008-03-20 2010-12-20 5992 BERRYHILL RD, SUITE 201, MILTON, FL, 325701013, US 5992 BERRYHILL RD, SUITE 201, MILTON, FL, 325701013, US

Contacts
Phone +1 850-626-9626
Fax 8506269606

Authorized person
Name KERI A RUSYNYK
Role OFFICE MANAGER
Phone 8507484420

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2023 200009224 2024-07-09 SANTA ROSA GASTROENTEROLOGY, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507484420
Plan sponsor’s address 3117 MERION DRIVE, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2024-07-09
Name of individual signing KERI RUSYNYK
Valid signature Filed with authorized/valid electronic signature
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2022 200009224 2023-09-19 SANTA ROSA GASTROENTEROLOGY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507484420
Plan sponsor’s address 3117 MERION DRIVE, MIRAMAR BEACH, FL, 32550

Signature of
Role Plan administrator
Date 2023-09-19
Name of individual signing KERI RUSYNYK
Valid signature Filed with authorized/valid electronic signature
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2021 200009224 2022-10-17 SANTA ROSA GASTROENTEROLOGY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507484420
Plan sponsor’s address 3117 MERION DRIVE, MIRAMAR BEACH, FL, 32550
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2020 200009224 2021-10-12 SANTA ROSA GASTROENTEROLOGY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8507484420
Plan sponsor’s address 3117 MERION DRIVE, MIRAMAR BEACH, FL, 32550
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2019 200009224 2020-10-10 SANTA ROSA GASTROENTEROLOGY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8506269626
Plan sponsor’s address 102 MACK BAYOU LOOP, SUITE 102, SANTA ROSA BEACH, FL, 32459
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2018 200009224 2019-08-12 SANTA ROSA GASTROENTEROLOGY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8506269626
Plan sponsor’s address 102 MACK BAYOU LOOP, SUITE 102, SANTA ROSA BEACH, FL, 32459
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2017 200009224 2018-09-13 SANTA ROSA GASTROENTEROLOGY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8506269626
Plan sponsor’s address 102 MACK BAYOU LOOP, SUITE 102, SANTA ROSA BEACH, FL, 32459
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2016 200009224 2017-10-16 SANTA ROSA GASTROENTEROLOGY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8506269626
Plan sponsor’s address 102 MACK BAYOU LOOP, SUITE 102, SANTA ROSA BEACH, FL, 32459
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2015 200009224 2016-10-11 SANTA ROSA GASTROENTEROLOGY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8506269626
Plan sponsor’s address 102 MACK BAYOU LOOP, SUITE 102, SANTA ROSA BEACH, FL, 32459
SANTA ROSA GASTROENTEROLOGY, INC. 401(K) PLAN 2014 200009224 2015-09-28 SANTA ROSA GASTROENTEROLOGY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 8506269626
Plan sponsor’s address 102 MACK BAYOU LOOP, SUITE 102, SANTA ROSA BEACH, FL, 32459

Key Officers & Management

Name Role Address
RUSYNYK RAPHAEL ADr. President 3117 MERION DR, MIRAMAR BEACH, FL, 32550
RUSYNYK KERI A Vice President 3117 MERION DR, MIRAMAR BEACH, FL, 32550
RUSYNYK RAPHAEL A Agent 3117 MERION DR, MIRAMAR BEACH, FL, 32550

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-04-29 3117 Merion Dr, Miramar Beach, FL 32550 -
CHANGE OF MAILING ADDRESS 2013-06-20 3117 Merion Dr, Miramar Beach, FL 32550 -
REGISTERED AGENT ADDRESS CHANGED 2013-06-20 3117 MERION DR, MIRAMAR BEACH, FL 32550 -

Documents

Name Date
ANNUAL REPORT 2024-04-29
ANNUAL REPORT 2023-04-27
ANNUAL REPORT 2022-04-29
ANNUAL REPORT 2021-04-29
ANNUAL REPORT 2020-04-02
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-04-23
ANNUAL REPORT 2017-04-27
ANNUAL REPORT 2016-02-23
ANNUAL REPORT 2015-04-28

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7858667105 2020-04-14 0491 PPP 141 MACK BAYOU LOOP, SANTA ROSA BEACH, FL, 32459-7194
Loan Status Date 2021-02-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 43435
Loan Approval Amount (current) 43435
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39334
Servicing Lender Name Trustmark National Bank
Servicing Lender Address 248 E Capitol St, JACKSON, MS, 39201-2503
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description New Business or 2 years or less
Project Address SANTA ROSA BEACH, WALTON, FL, 32459-7194
Project Congressional District FL-01
Number of Employees 5
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 39334
Originating Lender Name Trustmark National Bank
Originating Lender Address JACKSON, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 43749.9
Forgiveness Paid Date 2021-01-06

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RUSYNYK KERI A

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Companies related by address

3117 MERION DR, MIRAMAR BEACH, FL, 32550, US

ALEX AND KERI RUSYNYK, LLC

Date of last update: 01 Apr 2025

Sources: Florida Department of State

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