| Entity Name: | PURE SKIN DERMATOLOGY AND AESTHETICS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Feb 2008 (17 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 03 Oct 2016 (8 years ago) |
| Document Number: | L08000022075 |
| FEI/EIN Number | 45-4667817 |
| Address: | 7932 West Sand Lake Road, Suite 206, ORLANDO, FL, 32819, US |
| Mail Address: | 7932 West Sand Lake Road, Suite 206, ORLANDO, FL, 32819, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598025447 | 2012-05-25 | 2017-02-14 | 7932 W SAND LAKE RD, SUITE 206, ORLANDO, FL, 328197263, US | 7932 W SAND LAKE RD, SUITE 206, ORLANDO, FL, 328197263, US | |||||||||||||||||||||||
|
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| Phone | +1 407-900-2580 |
Authorized person
| Name | DR. DEBRA L GRAYMAN |
| Role | MGRM |
| Phone | 4079002580 |
Taxonomy
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| License Number | ME98190 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | GROUP NPI |
| Number | 1598025447 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRAYMAN DEBRA LMD | Agent | 7932 West Sand Lake Road, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| GRAYMAN DEBRA M | Managing Member | 7981 Chilton Dr, ORLANDO, FL, 32836 |
| Name | Role | Address |
|---|---|---|
| GRAYMAN TIMOTHY | Director | 7981 Chilton Dr, ORLANDO, FL, 32836 |
| LAING JANETT A | Director | 1353 Garrett Gilliam Drive, Ocoee, FL, 34761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-29 | 7932 West Sand Lake Road, Suite 206, ORLANDO, FL 32819 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-29 | 7932 West Sand Lake Road, Suite 206, ORLANDO, FL 32819 | No data |
| LC NAME CHANGE | 2016-10-03 | PURE SKIN DERMATOLOGY AND AESTHETICS, LLC | No data |
| REINSTATEMENT | 2016-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REINSTATEMENT | 2015-10-08 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| LC AMENDMENT | 2014-07-28 | No data | No data |
| LC AMENDMENT | 2014-06-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-14 | 7932 West Sand Lake Road, Suite 206, ORLANDO, FL 32819 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-03-26 |
| ANNUAL REPORT | 2018-01-17 |
| AMENDED ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2017-02-17 |
| AMENDED ANNUAL REPORT | 2016-10-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
