| Entity Name: | ROBERT S. CAPUTO, D.O., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Oct 1998 (26 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 12 Oct 2009 (15 years ago) |
| Document Number: | P98000086836 |
| FEI/EIN Number | 593537819 |
| Address: | 114 Cedar Avenue, CRESTVIEW, FL, 32536, US |
| Mail Address: | 114 Cedar Ave, CRESTVIEW, FL, 32536, US |
| ZIP code: | 32536 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790089407 | 2011-01-10 | 2011-01-27 | 194 E REDSTONE AVE STE B, CRESTVIEW, FL, 325395368, US | 194 E REDSTONE AVE STE B, CRESTVIEW, FL, 325395368, US | |||||||||||||||||||
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| Phone | +1 850-398-8873 |
| Fax | 8503988897 |
Authorized person
| Name | MRS. ROBERT SCOTT CAPUTO |
| Role | PROVIDER |
| Phone | 8503988873 |
Taxonomy
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| License Number | 0S005464 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT S. CAPUTO, D.O., P.A. EMPLOYEE STOCK OWNERSHIP PLAN | 2010 | 593537819 | 2011-10-20 | ROBERT S. CAPUTO, D.O., P.A. | 33 | |||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 593537819 |
| Plan administrator’s name | ROBERT S. CAPUTO, D.O., P.A. |
| Plan administrator’s address | 194 E. REDSTONE AVENUE, SUITE B, CRESTVIEW, FL, 32539 |
| Administrator’s telephone number | 8503988873 |
Number of participants as of the end of the plan year
| Active participants | 36 |
| Retired or separated participants receiving benefits | 1 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 37 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-20 |
| Name of individual signing | ROBERT S. CAPUTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1981-04-15 |
| Business code | 621111 |
| Sponsor’s telephone number | 8506892223 |
| Plan sponsor’s mailing address | 194 REDSTONE AVENUE EAST, SUITE B, CRESTVIEW, FL, 32539 |
| Plan sponsor’s address | 194 REDSTONE AVENUE EAST, SUITE B, CRESTVIEW, FL, 32539 |
Plan administrator’s name and address
| Administrator’s EIN | 593537819 |
| Plan administrator’s name | ROBERT S. CAPUTO, D.O., P.A. |
| Plan administrator’s address | 194 REDSTONE AVENUE EAST, SUITE B, CRESTVIEW, FL, 32539 |
| Administrator’s telephone number | 8506892223 |
Number of participants as of the end of the plan year
| Active participants | 36 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 36 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-02 |
| Name of individual signing | ROBERT S. CAPUTO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CAPUTO ROBERT S | Agent | 114 Cedar Avenue, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| CAPUTO ROBERT S | Director | 114 Cedar Avenue, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| CAPUTO ROBERT S | President | 114 Cedar Avenue, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| CAPUTO ROBERT S | Secretary | 114 Cedar Avenue, CRESTVIEW, FL, 32536 |
| Name | Role | Address |
|---|---|---|
| CAPUTO ROBERT S | Treasurer | 114 Cedar Avenue, CRESTVIEW, FL, 32536 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-08 | 114 Cedar Avenue, PMB 17, CRESTVIEW, FL 32536 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-08 | 114 Cedar Avenue, PMB 17, CRESTVIEW, FL 32536 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-08 | 114 Cedar Avenue, PMB 17, CRESTVIEW, FL 32536 | No data |
| CANCEL ADM DISS/REV | 2009-10-12 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| MERGER | 1998-10-09 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 900000020349 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-12 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
