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COASTAL CARDIOLOGY, P.A. - Florida Company Profile

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Company Details

Entity Name: COASTAL CARDIOLOGY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 16 Jun 2005 (20 years ago)
Date of dissolution: 28 Sep 2012 (13 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 28 Sep 2012 (13 years ago)
Document Number: P05000086946
FEI/EIN Number 203011763
Address: 16261 BASS ROAD, #300, FORT MYERS, FL, 33908, US
Mail Address: 16261 BASS ROAD, #300, FORT MYERS, FL, 33908, US
ZIP code: 33908
City: Fort Myers
County: Lee
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
LEE STEVEN T Director 16261 BASS RD SUITE 300., FORT MYERS, FL, 33908
GROHOWSKI ROBERT M Director 16261 BASS RD SUITE 300, FORT MYERS, FL, 33908
CONRAD JAMES A Director 16261 BASS RD SUITE 300, FORT MYERS, FL, 33908
TASCHNER BRIAN C Director 16261 BASS RD SUITE 300, FORT MYERS, FL, 33908
KYLE KEVIN A Agent 1380 ROYAL PALM SQUARE BLVD., FORT MYERS, FL, 33919

National Provider Identifier

NPI Number:
1174588255

Authorized Person:

Name:
DR. JAMES A. CONRAD
Role:
STAFF PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
Yes

Contacts:

Fax:
2392748867

Form 5500 Series

Employer Identification Number (EIN):
203011763
Plan Year:
2011
Number Of Participants:
24
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
27
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
26
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2012-09-28 - -
CHANGE OF PRINCIPAL ADDRESS 2009-04-01 16261 BASS ROAD, #300, FORT MYERS, FL 33908 -
CHANGE OF MAILING ADDRESS 2009-04-01 16261 BASS ROAD, #300, FORT MYERS, FL 33908 -
REGISTERED AGENT NAME CHANGED 2009-04-01 KYLE, KEVIN A -
REGISTERED AGENT ADDRESS CHANGED 2009-04-01 1380 ROYAL PALM SQUARE BLVD., FORT MYERS, FL 33919 -

Documents

Name Date
ANNUAL REPORT 2011-03-15
ANNUAL REPORT 2010-06-02
ANNUAL REPORT 2009-04-01
ANNUAL REPORT 2008-01-11
ANNUAL REPORT 2007-01-10
ANNUAL REPORT 2006-01-05
Domestic Profit 2005-06-16

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Date of last update: 02 Aug 2025

Sources: Florida Department of State