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  5. SUNCOAST OBSTETRICS & GYNECOLOGY, PA

SUNCOAST OBSTETRICS & GYNECOLOGY, PA

Company Details

Entity Name: SUNCOAST OBSTETRICS & GYNECOLOGY, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 12 Mar 2004 (21 years ago)
Last Event: CANCEL ADM DISS/REV
Event Date Filed: 06 Mar 2009 (16 years ago)
Document Number: P04000045681
FEI/EIN Number 20-0901238
Address: 7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL, 34429, US
Mail Address: PO BOX 1117, CRYSTAL RIVER, FL, 34423, US
ZIP code: 34429
County: Citrus
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1295923688 2007-10-10 2016-01-06 PO BOX 1117, CRYSTAL RIVER, FL, 344231117, US 582 SE 7TH AVE, CRYSTAL RIVER, FL, 344294840, US

Contacts
Phone +1 352-564-8245

Authorized person
Name MRS. STACEY ANN LAWLOR
Role ASSISTANT MANAGER
Phone 3525648245

Taxonomy
Taxonomy Code 207V00000X - Obstetrics & Gynecology Physician
License Number ME62824
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 269427100
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2023 200901238 2024-06-05 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2024-06-05
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2022 200901238 2023-07-31 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2023-07-31
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2021 200901238 2022-06-21 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2022-06-21
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2020 200901238 2021-08-02 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2021-08-02
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2019 200901238 2020-06-26 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2020-06-26
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2018 200901238 2019-07-29 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2017 200901238 2018-06-18 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2018-06-18
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature
SUNCOAST OBSTETRICS & GYNECOLOGY 401(K) PLAN 2016 200901238 2017-07-27 SUNCOAST OBSTETRICS & GYNECOLOGY, PA 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3525648245
Plan sponsor’s address 582 SE 7TH AVE, CRYSTAL RIVER, FL, 34429

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing STACEY LAWLOR
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
REDRICK SCOTT JMD Agent 7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL, 34429

President

Name Role Address
REDRICK SCOTT JMD President 7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL, 34429

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000052599 MEDICAL WEIGHT LOSS CENTER EXPIRED 2010-06-11 2015-12-31 No data P.O. BOX 1117, CRYSTAL RIVER, FL, 34423, US

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-10-17 7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL 34429 No data
CHANGE OF MAILING ADDRESS 2024-10-17 7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL 34429 No data
REGISTERED AGENT ADDRESS CHANGED 2024-10-17 7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL 34429 No data
REGISTERED AGENT NAME CHANGED 2014-02-11 REDRICK, SCOTT J, MD No data
CANCEL ADM DISS/REV 2009-03-06 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2008-09-26 No data No data

Documents

Name Date
ANNUAL REPORT 2025-01-22
AMENDED ANNUAL REPORT 2024-10-17
ANNUAL REPORT 2024-01-05
ANNUAL REPORT 2023-01-03
ANNUAL REPORT 2022-01-05
ANNUAL REPORT 2021-01-04
ANNUAL REPORT 2020-01-03
ANNUAL REPORT 2019-01-09
ANNUAL REPORT 2018-01-18
ANNUAL REPORT 2017-01-09

Related by officers

No related officers

Related by address

7394 W Gulf to Lake Hwy, CRYSTAL RIVER, FL, 34429, US

CITRUS LAND HOLDINGS, LLC EHT REAL ESTATE HOLDINGS, LLC FLORIDA FLIGHT PHYSICAL, LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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