| Entity Name: | DERMATOLOGY ASSOCIATES OF BAY COUNTY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
DERMATOLOGY ASSOCIATES OF BAY COUNTY, 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: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 15 Aug 1978 (47 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 08 Feb 1993 (32 years ago) |
| Document Number: | 582230 |
| FEI/EIN Number |
591847285
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1900 HARRISON AVE, PANAMA CITY, FL, 32405, US |
| Mail Address: | 1900 HARRISON AVE, PANAMA CITY, FL, 32405, US |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437444817 | 2011-06-14 | 2011-06-16 | 1900 HARRISON AVE, PANAMA CITY, FL, 324054542, US | 3025 6TH ST, MARIANNA, FL, 324461930, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-769-1668 |
| Fax | 8507852123 |
Authorized person
| Name | DR. ROBERT JOHN SIRAGUSA |
| Role | PRESIDENT |
| Phone | 8507691668 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS OF FL |
| Number | 99500 |
| Issuer | MEDICAID |
| Number | 000164600 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| DERMATOLOGY ASSOCIATES OF BAY COUNTY P.A. DEFINED BENEFIT PLAN | 2010 | 591847285 | 2011-07-04 | DERMATOLOGY ASSOCIATES OF BAY COUNTY P.A. | 25 | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 591847285 |
| Plan administrator’s name | DERMATOLOGY ASSOCIATES OF BAY COUNTY P.A. |
| Plan administrator’s address | 1900 HARRISON AVENUE, PANAMA CITY, FL, 32405 |
| Administrator’s telephone number | 8507859315 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| 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 that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-04 |
| Name of individual signing | ROBERT SIRAGUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2011-07-04 |
| Name of individual signing | ROBERT SIRAGUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2002-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8507859315 |
| Plan sponsor’s mailing address | 1900 HARRISON AVENUE, PANAMA CITY, FL, 32405 |
| Plan sponsor’s address | ROBERT SIRAGUSA, 1900 HARRISON AVENUE, PANAMA CITY, FL, 32405 |
Plan administrator’s name and address
| Administrator’s EIN | 591847285 |
| Plan administrator’s name | DERMATOLOGY ASSOCIATES OF BAY COUNTY P.A. |
| Plan administrator’s address | 1900 HARRISON AVENUE, PANAMA CITY, FL, 32405 |
| Administrator’s telephone number | 8507859315 |
Number of participants as of the end of the plan year
| Active participants | 19 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 4 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| 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 | 2010-09-16 |
| Name of individual signing | ROBERT SIRAGUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-09-16 |
| Name of individual signing | ROBERT SIRAGUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SIRAGUSA ROBERT J | President | 1900 HARRISON AVE, PANAMA CITY, FL, 32405 |
| Kovaleski Tina S | Secretary | 3000 W 27th Ct, PANAMA CITY, FL, 32405 |
| Kovaleski Tina S | Director | 3000 W 27th Ct, PANAMA CITY, FL, 32405 |
| KOVALESKI CHARLES R | Vice President | 1900 HARRISON AVE, PANAMA CITY, FL, 32405 |
| KOVALESKI CHARLES R | Director | 1900 HARRISON AVE, PANAMA CITY, FL, 32405 |
| SIRAGUSA ROBERT J | Agent | 1900 HARRISON AVE., PANAMA CITY, FL, 32405 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G25000042554 | BAY DERMATOLOGY | ACTIVE | 2025-03-26 | 2030-12-31 | - | 1900 HARRISON AVE, PANAMA CITY, FL, 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-01-27 | 1900 HARRISON AVE, PANAMA CITY, FL 32405 | - |
| REGISTERED AGENT NAME CHANGED | 2005-01-20 | SIRAGUSA, ROBERT JP | - |
| CHANGE OF MAILING ADDRESS | 1996-04-26 | 1900 HARRISON AVE, PANAMA CITY, FL 32405 | - |
| REGISTERED AGENT ADDRESS CHANGED | 1994-04-27 | 1900 HARRISON AVE., PANAMA CITY, FL 32405 | - |
| NAME CHANGE AMENDMENT | 1993-02-08 | DERMATOLOGY ASSOCIATES OF BAY COUNTY, P.A. | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-04 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-01-07 |
| ANNUAL REPORT | 2019-01-10 |
| ANNUAL REPORT | 2018-01-30 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-27 |
| ANNUAL REPORT | 2015-02-12 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PO | AWARD | DJBP0308LVB230658 | 2012-04-02 | 2012-04-03 | 2012-09-30 | |||||||||||||||||||||
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| Title | IGF::OT::IGF MEDICAL TREATMENT |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q504: MEDICAL- DERMATOLOGY |
Recipient Details
| Recipient | DERMATOLOGY ASSOCIATES OF BAY COUNTY, P.A. |
| UEI | E56KARCB4359 |
| Legacy DUNS | 109792721 |
| Recipient Address | 1900 HARRISON AVE, PANAMA CITY, 324054542, UNITED STATES |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7141297104 | 2020-04-14 | 0491 | PPP | 1900 Harrison Ave, Panama City, FL, 32405-4542 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
