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ATLANTIC DERMATOLOGY LLC

ATLANTIC DERMATOLOGY LLC - Florida Company Profile

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Company Details

Entity Name:	ATLANTIC DERMATOLOGY LLC
Jurisdiction:	FLORIDA
Filing Type:	Florida Limited Liability Co.
Status:	Active
Date Filed:	06 Jan 2005 (21 years ago)
Document Number:	L05000001644
FEI/EIN Number	202111643
Address:	1980 N. ATLANTIC AVE., SUITE 722, COCOA BEACH, FL, 32931, US
Mail Address:	1980 N. ATLANTIC AVE., SUITE 722, COCOA BEACH, FL, 32931, US
ZIP code:	32931
City:	Cocoa Beach
County:	Brevard
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
SMALLWOOD KRISTIN W	Agent	56 CRYSTAL RIVER DR, COCOA BEACH, FL, 32931
SMALLWOOD KRISTIN W	Manager	56 CRYSTAL RIVER, COCOA BEACH, FL, 32931

National Provider Identifier

NPI Number:

1306957378

Link:

View on NPI website

Authorized Person:

Name:

MRS. KRISTIN WIDICK SMALLWOOD

Role:

PRESIDENT

Phone:

3217848811

Taxonomy:

Selected Taxonomy:

207N00000X - Dermatology Physician

Is Primary:

No

Selected Taxonomy:

207NI0002X - Clinical & Laboratory Dermatological Immunology Physician

Is Primary:

No

Selected Taxonomy:

207NP0225X - Pediatric Dermatology Physician

Is Primary:

No

Selected Taxonomy:

207NS0135X - Procedural Dermatology Physician

Is Primary:

No

Contacts:

Phone:

+1 321-784-8811

Fax:

3217994424

Form 5500 Series

Employer Identification Number (EIN):

202111643

Plan Year:

2015

Number Of Participants:

4

Sponsors Telephone Number:

3217848811

File:

Plan Year:

2014

Number Of Participants:

5

Sponsors Telephone Number:

3217848811

File:

Plan Year:

2013

Number Of Participants:

5

Sponsors Telephone Number:

3217848811

File:

Plan Year:

2012

Number Of Participants:

6

Sponsors Telephone Number:

3217848811

File:

Plan Year:

2011

Number Of Participants:

6

Sponsors Telephone Number:

3217848811

File:

Events

Event Type	Filed Date	Value	Description
REGISTERED AGENT ADDRESS CHANGED	2025-01-07	56 CRYSTAL RIVER DR, COCOA BEACH, FL 32931	-
REGISTERED AGENT ADDRESS CHANGED	2008-01-08	56 CRYSTAL RIVER, COCOA BEACH, FL 32931	-
CHANGE OF PRINCIPAL ADDRESS	2005-08-18	1980 N. ATLANTIC AVE., SUITE 722, COCOA BEACH, FL 32931	-
CHANGE OF MAILING ADDRESS	2005-08-18	1980 N. ATLANTIC AVE., SUITE 722, COCOA BEACH, FL 32931	-

Documents

Name	Date
ANNUAL REPORT	2025-01-07
ANNUAL REPORT	2024-01-03
ANNUAL REPORT	2023-01-03
ANNUAL REPORT	2022-01-05
ANNUAL REPORT	2021-01-11
ANNUAL REPORT	2020-01-15
ANNUAL REPORT	2019-01-10
ANNUAL REPORT	2018-01-15
ANNUAL REPORT	2017-01-06
ANNUAL REPORT	2016-01-11

USAspending Awards / Financial Assistance

Date:

2020-04-30

Link:

View on USAspending

Awarding Agency Name:

Small Business Administration

Transaction Description:

TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.

Obligated Amount:

0.00

Face Value Of Loan:

55889.00

Total Face Value Of Loan:

55889.00

Date:

2020-04-30

Link:

View on USAspending

Awarding Agency Name:

Small Business Administration

Transaction Description:

TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.

Obligated Amount:

0.00

Face Value Of Loan:

55889.00

Total Face Value Of Loan:

55889.00

Paycheck Protection Program

Jobs Reported:

4

Initial Approval Amount:

$55,889

Date Approved:

2020-04-30

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$55,889

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$56,362.14

Servicing Lender:

Bank of America, National Association

Use of Proceeds:

Payroll: $55,889

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Date of last update: 02 Aug 2025

Sources: Florida Department of State