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  5. ANDLOS INSTITUTE, INC.

ANDLOS INSTITUTE, INC.

Company Details

Entity Name: ANDLOS INSTITUTE, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 15 Oct 2010 (14 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: P10000084734
FEI/EIN Number 273748768
Address: 2914 BEE RIDGE ROAD, SARASOTA, FL, 34239, US
Mail Address: 2914 BEE RIDGE ROAD, SARASOTA, FL, 34239, US
ZIP code: 34239
County: Sarasota
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871930370 2013-05-24 2013-05-24 2914 BEE RIDGE RD, SARASOTA, FL, 342397117, US 2914 BEE RIDGE RD, SARASOTA, FL, 342397117, US

Contacts
Phone +1 941-955-1815

Authorized person
Name ROBERT GREGORY CARLSON
Role MANAGER
Phone 9419551815

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number ME51783
State FL
Is Primary No
Taxonomy Code 261QH0100X - Health Service Clinic/Center
License Number ME51783
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANDLOS INSTITUTE INC 401(K) PROFIT SHARING PLAN 2016 205554135 2017-10-17 ANDLOS INSTITUTE 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541600
Sponsor’s telephone number 9419551815
Plan sponsor’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239

Signature of
Role Plan administrator
Date 2017-10-17
Name of individual signing ROB CARLSON
Valid signature Filed with authorized/valid electronic signature
ANDLOS INSTITUTE INC 401(K) PROFIT SHARING PLAN 2015 205554135 2016-10-21 ANDLOS INSTITUTE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 541600
Sponsor’s telephone number 9419551815
Plan sponsor’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239

Signature of
Role Plan administrator
Date 2016-10-21
Name of individual signing ROBERT CARLSON
Valid signature Filed with authorized/valid electronic signature
ANDLOS INSTITUTE INC 401(K) PROFIT SHARING PLAN 2014 205554135 2015-07-01 ANDLOS INSTITUTE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 541600
Sponsor’s telephone number 9419551815
Plan sponsor’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239

Signature of
Role Plan administrator
Date 2015-07-01
Name of individual signing ROBERT CARLSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-01
Name of individual signing ROBERT CARLSON
Valid signature Filed with authorized/valid electronic signature
ANDLOS INSTITUTE RETIREMENT TRUST 2013 205554135 2014-07-07 ANDLOS INSTITUTE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 541600
Sponsor’s telephone number 9419551815
Plan sponsor’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239

Signature of
Role Plan administrator
Date 2014-07-07
Name of individual signing BRYAN HOLMES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-07
Name of individual signing BRYAN HOLMES
Valid signature Filed with authorized/valid electronic signature
ANDLOS INSTITUTE RETIREMENT TRUST 2012 205554135 2013-06-28 ANDLOS INSTITUTE 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 541600
Sponsor’s telephone number 9419551815
Plan sponsor’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239

Signature of
Role Plan administrator
Date 2013-06-28
Name of individual signing ROBERT CARLSON
Valid signature Filed with authorized/valid electronic signature
ANDLOS INSTITUTE 2011 205554135 2012-07-30 ANDLOS INSTITUTE 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 541600
Sponsor’s telephone number 9419551815
Plan sponsor’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239

Plan administrator’s name and address
Administrator’s EIN 205554135
Plan administrator’s name ANDLOS INSTITUTE
Plan administrator’s address 2914 BEE RIDGE RD, SARASOTA, FL, 34239
Administrator’s telephone number 9419551815

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing ROBERT CARLSON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-30
Name of individual signing ROBERT CARLSON
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CARLSON ROBERT G Agent 2914 BEE RIDGE ROAD, SARASOTA, FL, 34239

Director

Name Role Address
CARLSON ROBERT G Director 2914 BEE RIDGE ROAD, SARASOTA, FL, 34239

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2017-09-22 No data No data
CHANGE OF PRINCIPAL ADDRESS 2011-04-14 2914 BEE RIDGE ROAD, SARASOTA, FL 34239 No data
CHANGE OF MAILING ADDRESS 2011-04-14 2914 BEE RIDGE ROAD, SARASOTA, FL 34239 No data
REGISTERED AGENT ADDRESS CHANGED 2011-04-14 2914 BEE RIDGE ROAD, SARASOTA, FL 34239 No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J12000677990 TERMINATED 1000000298282 SARASOTA 2012-10-15 2022-10-17 $ 432.74 STATE OF FLORIDA, DEPARTMENT OF REVENUE, SARASOTA SERVICE CENTER, 1991 MAIN ST STE 240, SARASOTA FL342365940
J12000701246 TERMINATED 1000000380415 SARASOTA 2012-10-15 2022-10-17 $ 518.55 STATE OF FLORIDA, DEPARTMENT OF REVENUE, SARASOTA SERVICE CENTER, 1991 MAIN ST STE 240, SARASOTA FL342365940

Documents

Name Date
ANNUAL REPORT 2016-01-15
ANNUAL REPORT 2015-03-01
ANNUAL REPORT 2014-04-14
AMENDED ANNUAL REPORT 2013-02-21
ANNUAL REPORT 2013-01-28
ANNUAL REPORT 2012-03-30
ANNUAL REPORT 2011-04-14
Off/Dir Resignation 2010-10-15
Domestic Profit 2010-10-15

Related by officers

CARLSON ROBERT G

ANDLOS INSTITUTE OF PREVENTATIVE MEDICINE INC STEELE INNOVATIONS L.L.C. STEELE PUBLICATIONS L.L.C. ROBERT CARLSON MD LLC GULF COAST HEART AND LUNG SURGERY, P.A. PALM BEACH REJUVENATION OF SARASOTA, INC. FLORIDA REJUVENATION INSTITUTE, LLC ROBERT G. CARLSON, M.D., F.A.C.S., P.L.

Related by address

2914 BEE RIDGE ROAD, SARASOTA, FL, 34239, US

STEELE INNOVATIONS L.L.C.

2914 BEE RIDGE ROAD, SARASOTA, FL, 34239, US

STEELE INNOVATIONS L.L.C.

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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