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  5. EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A.

EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A.

Company Details

Entity Name: EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 04 Aug 2010 (14 years ago)
Date of dissolution: 03 Mar 2023 (2 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 03 Mar 2023 (2 years ago)
Document Number: P10000064181
FEI/EIN Number 273206586
Address: 103 EAST 23RD ST, PANAMA CITY, FL, 32405, US
Mail Address: 103 EAST 23RD ST, PANAMA CITY, FL, 32405, US
ZIP code: 32405
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1427364405 2010-08-27 2011-07-21 103 E 23RD ST, PANAMA CITY, FL, 324054501, US 103 E 23RD ST, PANAMA CITY, FL, 324054501, US

Contacts
Phone +1 850-769-0338
Fax 8507856088

Authorized person
Name MR. ROBERT GARY COX
Role OFFICE ADMINISTRATOR
Phone 8507690338

Taxonomy
Taxonomy Code 207V00000X - Obstetrics & Gynecology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 002699900
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A. PROFIT SHARING PLAN 2012 273206586 2013-03-22 EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A. 52
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8507690338
Plan sponsor’s address 103 E. 23RD STREET, PANAMA CITY, FL, 32405

Plan administrator’s name and address
Administrator’s EIN 273206586
Plan administrator’s name EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A.
Plan administrator’s address 103 E. 23RD STREET, PANAMA CITY, FL, 32405
Administrator’s telephone number 8507690338

Signature of
Role Plan administrator
Date 2013-03-22
Name of individual signing MICHAEL A INGRAM
Valid signature Filed with authorized/valid electronic signature
EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A. PSP 2012 273206586 2013-12-13 EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8507690338
Plan sponsor’s address 103 E. 23RD STREET, PANAMA CITY, FL, 32405

Plan administrator’s name and address
Administrator’s EIN 273206586
Plan administrator’s name EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A.
Plan administrator’s address 103 E. 23RD STREET, PANAMA CITY, FL, 32405
Administrator’s telephone number 8507690338

Signature of
Role Plan administrator
Date 2013-12-13
Name of individual signing MICHAEL A INGRAM
Valid signature Filed with authorized/valid electronic signature
EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A. PROFIT SHARING PLAN 2011 273206586 2012-03-26 EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A. 49
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8507690338
Plan sponsor’s address 103 E. 23RD STREET, PANAMA CITY, FL, 32405

Plan administrator’s name and address
Administrator’s EIN 273206586
Plan administrator’s name EMERALD COAST OBSTETRICS & GYNECOLOGY, P.A.
Plan administrator’s address 103 E. 23RD STREET, PANAMA CITY, FL, 32405
Administrator’s telephone number 8507690338

Signature of
Role Plan administrator
Date 2012-03-26
Name of individual signing MICHAEL A INGRAM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BRELAND HENRY B Agent 103 EAST 23RD ST, PANAMA CITY, FL, 32405

President

Name Role Address
BRELAND HENRY B President 103 EAST 23RD ST, PANAMA CITY, FL, 32405

Vice President

Name Role Address
RAMIE GEORGE B Vice President 103 EAST 23RD ST, PANAMA CITY, FL, 32405

Treasurer

Name Role Address
BRELAND HENRY B Treasurer 103 EAST 23RD ST, PANAMA CITY, FL, 32405

Secretary

Name Role Address
WOLF SAMUEL B Secretary 103 EAST 23RD ST, PANAMA CITY, FL, 32405

Shar

Name Role Address
PENNINGTON TONI L Shar 103 EAST 23RD ST, PANAMA CITY, FL, 32405
BAIN KIMBERLY B Shar 103 EAST 23RD ST, PANAMA CITY, FL, 32405

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2023-03-03 No data No data
REGISTERED AGENT NAME CHANGED 2020-03-18 BRELAND, HENRY B No data
CHANGE OF PRINCIPAL ADDRESS 2012-02-15 103 EAST 23RD ST, PANAMA CITY, FL 32405 No data
CHANGE OF MAILING ADDRESS 2012-02-15 103 EAST 23RD ST, PANAMA CITY, FL 32405 No data
REGISTERED AGENT ADDRESS CHANGED 2012-02-15 103 EAST 23RD ST, PANAMA CITY, FL 32405 No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2023-03-03
ANNUAL REPORT 2022-02-28
ANNUAL REPORT 2021-03-03
ANNUAL REPORT 2020-03-18
ANNUAL REPORT 2019-01-29
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-01-20
ANNUAL REPORT 2016-01-27
AMENDED ANNUAL REPORT 2015-09-10
ANNUAL REPORT 2015-01-26

Related by officers

BRELAND HENRY B

EMERALD COAST OBGYN, INC.

RAMIE GEORGE B

RAMIE FAMILY LIMITED PARTNERSHIP EMERALD COAST OBGYN, INC.

WOLF SAMUEL B

SURGICAL ASSISTANTS OF NW FLORIDA, LLC VAGICIAN ENTERPRISES, LLC WOLF VARIETY ENTERTAINMENT, LLC CAYSON RANCH, INC. EMERALD COAST OBGYN, INC.

PENNINGTON TONI L

PENNINGTON PLANTATION LLC EMERALD COAST OBGYN, INC.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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