| Entity Name: | INTEGRATED DERMATOLOGY OF SOUTH MIAMI LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Jul 2009 (16 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Sep 2009 (15 years ago) |
| Document Number: | L09000066880 |
| FEI/EIN Number | 27-0524361 |
| Mail Address: | 4700 Exchange Ct, SUITE 110, BOCA RATON, FL, 33431, US |
| Address: | 4700 Exchange Ct., SUITE 110, BOCA RATON, FL, 33431, US |
| ZIP code: | 33431 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265661219 | 2009-07-13 | 2024-02-01 | 4700 EXCHANGE CT STE 110, BOCA RATON, FL, 334314450, US | 7800 SW 87TH AVE, SUITE B200, MIAMI, FL, 331733570, US | |||||||||||||||||
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| Phone | +1 561-314-2000 |
| Phone | +1 305-279-6060 |
| Fax | 3052796548 |
Authorized person
| Name | ANDREW QUEEN |
| Role | MANAGER |
| Phone | 5613142000 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MIAMI DERMATOLOGY AND LASER INSTITUTE 401K RETIREMENT PLAN | 2023 | 270524361 | 2024-06-28 | INTEGRATED DERMATOLOGY OF SOUTH MIAMI, LLC | 22 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-06-28 |
| Name of individual signing | ANDREW WAIBEL |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3052796060 |
| Plan sponsor’s address | 7800 SW 87TH AVE SUITE B-200, MIAMI, FL, 33173 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-13 |
| Name of individual signing | ANDREW WAIBEL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 3052796060 |
| Plan sponsor’s address | 7800 SW 87TH AVE SUITE B-200, MIAMI, FL, 33173 |
Signature of
| Role | Plan administrator |
| Date | 2024-06-28 |
| Name of individual signing | ANDREW WAIBEL |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role |
|---|---|
| BROWARD-DADE DERM LLC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000014763 | MIAMI DERMATOLOGY & LASER INSTITUTE | ACTIVE | 2012-02-10 | 2027-12-31 | No data | 7800 SW 87TH AVENUE, SUITE B200, MIAMI, FL, 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-23 | 4700 Exchange Ct., SUITE 110, BOCA RATON, FL 33431 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-23 | 4700 Exchange Ct., SUITE 110, BOCA RATON, FL 33431 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-23 | Corporate Creations Network Inc. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-08 | 801 US HIGHWAY 1, NORTH PALM BEACH, FL 33408 | No data |
| LC AMENDMENT | 2009-09-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-17 |
| ANNUAL REPORT | 2023-03-23 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-28 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-03-14 |
| ANNUAL REPORT | 2015-04-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
