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  5. MICHELLE E. KOLB, M.D., P.A.

MICHELLE E. KOLB, M.D., P.A.

Company Details

Entity Name: MICHELLE E. KOLB, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 13 Jan 2006 (19 years ago)
Date of dissolution: 29 Jan 2013 (12 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 29 Jan 2013 (12 years ago)
Document Number: P06000007134
FEI/EIN Number 204124016
Address: 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 33647
Mail Address: 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 33647
ZIP code: 33647
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780651638 2006-02-28 2009-06-04 18055 HIGHWOODS PRESERVE PKWY, TAMPA, FL, 336471761, US 18055 HIGHWOODS PRESERVE PKWY, TAMPA, FL, 336471761, US

Contacts
Phone +1 813-631-7788
Fax 8138669588

Authorized person
Name MICHELLE E. KOLB
Role OWNER
Phone 8136317788

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
License Number 601629
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MICHELLE E. KOLB, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2013 204124016 2014-05-14 MICHELLE E. KOLB, M.D., P.A. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8137136102
Plan sponsor’s address 3040 OASIS GRAND BOULEVARD, UNIT 2108, FORT MYERS, FL, 339161607

Signature of
Role Plan administrator
Date 2014-05-14
Name of individual signing STEPHEN A. BROOKS
Valid signature Filed with authorized/valid electronic signature
MICHELLE E. KOLB, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2013 204124016 2014-05-13 MICHELLE E. KOLB, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8137136102
Plan sponsor’s address 3040 OASIS GRAND BOULEVARD, UNIT 2108, FORT MYERS, FL, 339161607

Signature of
Role Plan administrator
Date 2014-05-13
Name of individual signing STEPHEN A. BROOKS
Valid signature Filed with authorized/valid electronic signature
MICHELLE E. KOLB, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2012 204124016 2013-06-13 MICHELLE E. KOLB, M.D., P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8136317788
Plan sponsor’s address 3040 OASIS GRAND BOULEVARD, UNIT 2108, FORT MYERS, FL, 339161607

Signature of
Role Plan administrator
Date 2013-06-13
Name of individual signing MICHELLE E. KOLB, M.D.
Valid signature Filed with authorized/valid electronic signature
MICHELLE E. KOLB, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2011 204124016 2012-10-15 MICHELLE E. KOLB, M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8136317788
Plan sponsor’s address 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 336471761

Plan administrator’s name and address
Administrator’s EIN 204124016
Plan administrator’s name MICHELLE E. KOLB, M.D., P.A.
Plan administrator’s address 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 336471761
Administrator’s telephone number 8136317788

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing STEPHEN A. BROOKS
Valid signature Filed with authorized/valid electronic signature
MICHELLE E. KOLB, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2010 204124016 2011-05-27 MICHELLE E. KOLB, M.D., P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8136317788
Plan sponsor’s address 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 336471761

Plan administrator’s name and address
Administrator’s EIN 204124016
Plan administrator’s name MICHELLE E. KOLB, M.D., P.A.
Plan administrator’s address 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 336471761
Administrator’s telephone number 8136317788

Signature of
Role Plan administrator
Date 2011-05-27
Name of individual signing MICHELLE E. KOLB, M.D.
Valid signature Filed with authorized/valid electronic signature
MICHELLE E. KOLB, M.D., P.A. 401(K) PROFIT SHARING PLAN AND TRUST 2009 204124016 2010-10-01 MICHELLE E. KOLB, M.D., P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 8136317788
Plan sponsor’s address 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 33647

Plan administrator’s name and address
Administrator’s EIN 204124016
Plan administrator’s name MICHELLE E. KOLB, M.D., P.A.
Plan administrator’s address 18055 HIGHWOODS PRESERVE PARKWAY, TAMPA, FL, 33647
Administrator’s telephone number 8136317788

Signature of
Role Plan administrator
Date 2010-09-30
Name of individual signing MELANIE BARRY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KOLB MICHELLE E Agent 2171 SWEETBROOM CIRCLE, LUTZ, FL, 33559

Director

Name Role Address
KOLB MICHELLE E Director 2171 SWEETBROOM CIRCLE, LUTZ, FL, 33559

President

Name Role Address
KOLB MICHELLE E President 2171 SWEETBROOM CIRCLE, LUTZ, FL, 33559

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2013-01-29 No data No data
REGISTERED AGENT ADDRESS CHANGED 2012-04-26 2171 SWEETBROOM CIRCLE, LUTZ, FL 33559 No data
REGISTERED AGENT NAME CHANGED 2009-04-16 KOLB, MICHELLE E No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2013-01-29
ANNUAL REPORT 2012-04-26
ANNUAL REPORT 2011-02-18
ANNUAL REPORT 2010-02-16
ANNUAL REPORT 2009-04-16
ANNUAL REPORT 2008-04-25
ANNUAL REPORT 2007-05-01
Domestic Profit 2006-01-13

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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