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CLEARWATER DERMATOLOGY, P.A. - Florida Company Profile

Company Details

Entity Name: CLEARWATER DERMATOLOGY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

CLEARWATER DERMATOLOGY, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.

Status: Inactive

The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.

Date Filed: 01 Jul 1977 (48 years ago)
Date of dissolution: 28 Sep 2018 (6 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 28 Sep 2018 (6 years ago)
Document Number: 538243
FEI/EIN Number 591748009

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1122 DRUID ROAD, CLEARWATER, FL, 33756
Mail Address: 1122 DRUID ROAD, CLEARWATER, FL, 33756
ZIP code: 33756
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780659094 2006-02-21 2013-12-30 1122 DRUID RD E, CLEARWATER, FL, 337564100, US 1122 DRUID RD E, CLEARWATER, FL, 337564100, US

Contacts

Phone +1 727-461-2282

Authorized person

Name DR. ROGER STEVEN GOLOMB
Role PRESIDENT
Phone 7274612282

Taxonomy

Taxonomy Code 207N00000X - Dermatology Physician
License Number ME0021279
State FL
Is Primary Yes

Other Provider Identifiers

Issuer AETNA PROV CLWR DERM
Number 0004563725
State FL
Issuer UHC GROUP # CLWR DERM
Number 0300627
State FL
Issuer MEDICAID
Number 250114700
State FL

Key Officers & Management

Name Role Address
GOLOMB, ROGER S, M.D. Director 1122 DRUID ROAD, CLEARWATER, FL, 33756
BURNS, GEORGE E, M.D. President 1122 DRUID ROAD., CLEARWATER, FL, 33756
BURNS, GEORGE E, M.D. Director 1122 DRUID ROAD., CLEARWATER, FL, 33756
GOLOMB, ROGER S., M.D. TPD 1122 DRUID ROAD, CLEARWATER, FL, 33756
GOLOMB, ROGER S. Agent 1122 DRUID ROAD, CLEARWATER, FL, 33756
GOLOMB, ROGER S, M.D. Secretary 1122 DRUID ROAD, CLEARWATER, FL, 33756

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2018-09-28 - -
CHANGE OF PRINCIPAL ADDRESS 1999-02-22 1122 DRUID ROAD, CLEARWATER, FL 33756 -
CHANGE OF MAILING ADDRESS 1999-02-22 1122 DRUID ROAD, CLEARWATER, FL 33756 -
REGISTERED AGENT ADDRESS CHANGED 1999-02-22 1122 DRUID ROAD, CLEARWATER, FL 33756 -
NAME CHANGE AMENDMENT 1988-06-30 CLEARWATER DERMATOLOGY, P.A. -

Documents

Name Date
ANNUAL REPORT 2017-03-07
ANNUAL REPORT 2016-03-17
ANNUAL REPORT 2015-02-24
ANNUAL REPORT 2014-01-07
ANNUAL REPORT 2013-04-02
ANNUAL REPORT 2012-01-26
ANNUAL REPORT 2011-02-22
ANNUAL REPORT 2010-02-23
ANNUAL REPORT 2009-01-29
ANNUAL REPORT 2008-01-10

Date of last update: 01 Mar 2025

Sources: Florida Department of State