| Entity Name: | COASTAL ALLERGY & ASTHMA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 06 Dec 2004 (20 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P04000163795 |
| FEI/EIN Number | 202225843 |
| Address: | 3540 Preserve Blvd, PANAMA CITY Beach, FL, 32408, US |
| Mail Address: | 3540 Preserve Blvd, PANAMA CITY BEACH, FL, 32408, US |
| ZIP code: | 32408 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255529772 | 2007-10-10 | 2011-09-13 | 3228 EAST 15TH STREET, PANAMA CITY, FL, 32405, US | 3228 EAST 15TH STREET, PANAMA CITY, FL, 32405, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 850-784-2611 |
| Fax | 8507842614 |
Authorized person
| Name | DR. BINITA AMIN |
| Role | OWNER |
| Phone | 8507842611 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME90802 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 274657300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AMIN BINITA | Agent | 3540 Preserve Blvd, Panama City Beach, FL, 32408 |
| Name | Role | Address |
|---|---|---|
| AMIN BINITA V | President | 3540 Preserve Blvd, Panama City Beach, FL, 32408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-01-25 | 3540 Preserve Blvd, PANAMA CITY Beach, FL 32408 | No data |
| CHANGE OF MAILING ADDRESS | 2016-01-25 | 3540 Preserve Blvd, PANAMA CITY Beach, FL 32408 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-05 | 3540 Preserve Blvd, Panama City Beach, FL 32408 | No data |
| REINSTATEMENT | 2013-02-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-02-20 |
| ANNUAL REPORT | 2014-03-05 |
| REINSTATEMENT | 2013-02-28 |
| ANNUAL REPORT | 2011-02-22 |
| ANNUAL REPORT | 2010-04-21 |
| ANNUAL REPORT | 2009-03-30 |
| ANNUAL REPORT | 2008-04-28 |
| ANNUAL REPORT | 2007-04-26 |
| ANNUAL REPORT | 2006-05-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
