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COASTAL RADIOLOGY ASSOCIATES, P.A. - Florida Company Profile

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Company Details

Entity Name: COASTAL RADIOLOGY ASSOCIATES, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 09 Apr 2009 (16 years ago)
Date of dissolution: 02 Sep 2014 (11 years ago)
Last Event: CONVERSION
Event Date Filed: 02 Sep 2014 (11 years ago)
Document Number: P09000032025
FEI/EIN Number 264653361
Address: ATTN: RADIOLOGY DEPARTMENT, 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 32547-6708
Mail Address: C/O ADVOCATE, INC., 10567 SAWMILL PARKWAY SUITE 100, POWELL, OH, 43065
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BROBECK BRADLEY R President 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 325476708
BROBECK BRADLEY R Secretary 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 325476708
BROBECK BRADLEY R Director 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 325476708
CAZENAVE CRAIG R Treasurer 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 325476708
CAZENAVE CRAIG R Vice President 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 325476708
CAZENAVE CRAIG R Director 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL, 325476708
PIERCE ROBERT A Agent 123 SOUTH CALHOUN STREET, TALLAHASSEE, FL, 323011517

National Provider Identifier

NPI Number:
1750524393

Authorized Person:

Name:
DR. BRADLEY ROSS BROBECK
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
264653361
Plan Year:
2020
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
6
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
CONVERSION 2014-09-02 - CONVERSION MEMBER. NON-QUALIFIED CORPORATION WAS COASTAL RADIOLOGY ASSOCIATES, LLC. CONVERSION NUMBER 700000143827
REGISTERED AGENT NAME CHANGED 2010-08-04 PIERCE, ROBERT A -
REGISTERED AGENT ADDRESS CHANGED 2010-08-04 123 SOUTH CALHOUN STREET, TALLAHASSEE, FL 32301-1517 -
CHANGE OF MAILING ADDRESS 2010-04-27 ATTN: RADIOLOGY DEPARTMENT, 1000 MAR-WALT DRIVE, FORT WALTON BEACH, FL 32547-6708 -

Documents

Name Date
Conversion 2014-09-02
ANNUAL REPORT 2014-04-14
ANNUAL REPORT 2013-03-25
ANNUAL REPORT 2012-03-02
ANNUAL REPORT 2011-03-16
ANNUAL REPORT 2010-04-27
Domestic Profit 2009-04-09

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Date of last update: 02 Aug 2025

Sources: Florida Department of State