| Entity Name: | TOMAN ORTHOPEDICS AND SPORTS MEDICINE, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 05 Jun 2013 (12 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P13000048976 |
| FEI/EIN Number | 80-0931962 |
| Address: | 1786 NW 2nd Ave, Boca Raton, FL 33432 |
| Mail Address: | 21346 Saint Andrews Blvd., #121, BOCA RATON, FL 33433 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962841163 | 2013-06-20 | 2013-06-20 | 21346 SAINT ANDREWS BLVD, SUITE 121, BOCA RATON, FL, 334332432, US | 7301A W PALMETTO PARK RD, #100B, BOCA RATON, FL, 334333409, US | |||||||||||||||
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| Phone | +1 561-221-6895 |
| Fax | 5612216896 |
Authorized person
| Name | CHARLES V TOMAN |
| Role | OWNER |
| Phone | 5612216895 |
Taxonomy
| Taxonomy Code | 207XX0005X - Sports Medicine (Orthopaedic Surgery) Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WEALTHY AND WISE 401(K) PLAN | 2020 | 800931962 | 2021-07-22 | TOMAN ORTHOPEDICS AND SPORTS MEDICINE, PA | 2 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 452945096 |
| Plan administrator’s name | ERISA WISE, LLC |
| Plan administrator’s address | PO BOX 1002, MACKINAW, IL, 61755 |
| Administrator’s telephone number | 9253376069 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-22 |
| Name of individual signing | STEPHANIE BANISTER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2014-03-24 |
| Business code | 621111 |
| Sponsor’s telephone number | 5613251616 |
| Plan sponsor’s address | 7301A WEST PALMETTO PARK ROAD, SUITE 100B, BOCA RATON, FL, 33443 |
Plan administrator’s name and address
| Administrator’s EIN | 452945096 |
| Plan administrator’s name | ERISA WISE, LLC |
| Plan administrator’s address | PO BOX 1002, MACKINAW, IL, 61755 |
| Administrator’s telephone number | 9253376069 |
Signature of
| Role | Plan administrator |
| Date | 2020-10-04 |
| Name of individual signing | STEPHANIE BANISTER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2014-03-24 |
| Business code | 621111 |
| Sponsor’s telephone number | 5613251616 |
| Plan sponsor’s address | 7301A WEST PALMETTO PARK ROAD, SUITE 100B, BOCA RATON, FL, 33443 |
Plan administrator’s name and address
| Administrator’s EIN | 452945096 |
| Plan administrator’s name | ERISA WISE, LLC |
| Plan administrator’s address | PO BOX 1002, MACKINAW, IL, 61755 |
| Administrator’s telephone number | 9253376069 |
Signature of
| Role | Plan administrator |
| Date | 2019-08-16 |
| Name of individual signing | STEPHANIE BANISTER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| SLPA, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Toman, Charles V, MD | President | 21346 Saint Andrews Blvd., #121 BOCA RATON, FL 33433 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-27 | 1786 NW 2nd Ave, Boca Raton, FL 33432 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-16 | 1786 NW 2nd Ave, Boca Raton, FL 33432 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-01-16 | SLPA, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-01-16 | 201 N.E. First Ave, Delray Beach, FL 33444 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J19000299691 | LAPSED | 502016CA012957 | 15TH JUDICIAL CIRCUIT | 2019-03-01 | 2024-05-01 | $1,953,671.95 | RICHMOND BROOKS, IV, 6503 N. MILITARY TRAIL, 1504, BOCA RATON, FLORIDA 33486 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-02-27 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-16 |
| AMENDED ANNUAL REPORT | 2017-01-26 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-03-20 |
| Reg. Agent Change | 2014-09-08 |
| Reg. Agent Change | 2014-03-26 |
| ANNUAL REPORT | 2014-02-03 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
