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  5. MCDONNELL DERMATOLOGY LLC

MCDONNELL DERMATOLOGY LLC

Company Details

Entity Name: MCDONNELL DERMATOLOGY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 20 Apr 2010 (15 years ago)
Date of dissolution: 22 Sep 2023 (a year ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 22 Sep 2023 (a year ago)
Document Number: L10000042247
FEI/EIN Number 800581221
Mail Address: 18222 US Hwy 41 N, Lutz, FL, 33549, US
Address: 25097 OLYMPIA AVE STE 202, PUNTA GORDA, FL, 33950
ZIP code: 33950
County: Charlotte
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609189042 2010-07-14 2010-07-31 25097 OLYMPIA AVE, STE 204, PUNTA GORDA, FL, 339503903, US 25097 OLYMPIA AVE, STE 204, PUNTA GORDA, FL, 339503903, US

Contacts
Phone +1 941-205-3376
Phone +1 941-205-6676

Authorized person
Name JONELLE K MCDONNELL
Role OWNER
Phone 9412053376

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number ME104122
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAL LICENSE NUMBER
Number ME104122
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN TRUST 2021 800581221 2022-08-05 MCDONNELL DERMATOLOGY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN TRUST 2021 800581221 2022-12-29 MCDONNELL DERMATOLOGY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN TRUST 2020 800581221 2021-03-24 MCDONNELL DERMATOLOGY 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN TRUST 2019 800581221 2020-06-22 MCDONNELL DERMATOLOGY 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN TRUST 2018 800581221 2019-03-25 MCDONNELL DERMATOLOGY 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN AND TRUST 2017 800581221 2018-03-24 MCDONNELL DERMATOLOGY 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950

Signature of
Role Plan administrator
Date 2018-03-24
Name of individual signing DR. JONELLE MCDONNELL
Valid signature Filed with authorized/valid electronic signature
MCDONNELL DERMATOLOGY 401(K) PROFIT SHARING PLAN AND TRUST 2016 800581221 2017-04-26 MCDONNELL DERMATOLOGY 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 E. OLYMPIA AVENUE, #204, PUNTA GORDA, FL, 33950

Signature of
Role Plan administrator
Date 2017-04-26
Name of individual signing DR. JONELLE MCDONNELL
Valid signature Filed with authorized/valid electronic signature
MCDONNELL DERMATOLOGY 401 K PROFIT SHARING PLAN TRUST 2015 800581221 2016-06-07 MCDONNELL DERMATOLOGY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 OLYMPIA AVE SUITE 202, PUNTA GORDA, FL, 339503903

Signature of
Role Plan administrator
Date 2016-06-07
Name of individual signing JOHN D COLLINS
Valid signature Filed with authorized/valid electronic signature
MCDONNELL DERMATOLOGY 401 K PROFIT SHARING PLAN TRUST 2014 800581221 2015-07-28 MCDONNELL DERMATOLOGY 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 OLYMPIA AVE SUITE 202, PUNTA GORDA, FL, 339503903

Signature of
Role Plan administrator
Date 2015-07-28
Name of individual signing JOHN D COLLINS
Valid signature Filed with authorized/valid electronic signature
MCDONNELL DERMATOLOGY 401 K PROFIT SHARING PLAN TRUST 2013 800581221 2014-07-17 MCDONNELL DERMATOLOGY 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 9412053376
Plan sponsor’s address 25097 OLYMPIA AVE SUITE 202, PUNTA GORDA, FL, 339503903

Signature of
Role Plan administrator
Date 2014-07-17
Name of individual signing JOHN COLLINS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Ewanowski Rebecca Agent 18222 US Hwy 41 N, Lutz, FL, 33549

Manager

Name Role Address
Ewanowski Christopher Dr. Manager 18222 US Hwy 41 N, Lutz, FL, 33549

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 No data No data
CHANGE OF MAILING ADDRESS 2022-02-08 25097 OLYMPIA AVE STE 202, PUNTA GORDA, FL 33950 No data
REGISTERED AGENT NAME CHANGED 2022-02-08 Ewanowski, Rebecca No data
REGISTERED AGENT ADDRESS CHANGED 2022-02-08 18222 US Hwy 41 N, Lutz, FL 33549 No data
LC STMNT OF RA/RO CHG 2022-01-13 No data No data
CHANGE OF PRINCIPAL ADDRESS 2012-06-29 25097 OLYMPIA AVE STE 202, PUNTA GORDA, FL 33950 No data

Documents

Name Date
ANNUAL REPORT 2022-02-08
CORLCRACHG 2022-01-13
ANNUAL REPORT 2021-01-13
ANNUAL REPORT 2020-03-18
ANNUAL REPORT 2019-02-27
ANNUAL REPORT 2018-03-28
ANNUAL REPORT 2017-01-16
ANNUAL REPORT 2016-03-30
ANNUAL REPORT 2015-01-12
ANNUAL REPORT 2014-04-21

Related by officers

Ewanowski Christopher Dr.

PRESTIGE DERMATOLOGY, INC.

Ewanowski Rebecca

EWAN HOLDCO, LLC CRWLCZ, LLC PRESTIGE DERMATOLOGY, INC. COUNTRYSIDE DERMATOLOGY AND LASER CENTER, INC. DERMATOLOGY SPECIALISTS OF NORTH FLORIDA, INC.

Related by address

18222 US Hwy 41 N, Lutz, FL, 33549, US

COUNTRYSIDE DERMATOLOGY AND LASER CENTER, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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