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  5. MIDSTATE SKIN INSTITUTE, LLC

MIDSTATE SKIN INSTITUTE, LLC

Company Details

Entity Name: MIDSTATE SKIN INSTITUTE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 24 Feb 2012 (13 years ago)
Document Number: L12000026981
FEI/EIN Number 454674459
Address: 1740 SE 18th St, Ocala, FL, 34471, US
Mail Address: 1740 SE 18th St, Ocala, FL, 34471, US
ZIP code: 34471
County: Marion
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912258989 2012-09-30 2023-08-28 1740 SE 18TH ST STE 1102, OCALA, FL, 344715447, US 1740 SE 18TH ST STE 1102, OCALA, FL, 344715447, US

Contacts
Phone +1 352-512-0092
Fax 3525120093

Authorized person
Name ASHLEY CAUTHEN
Role PRESIDENT/MANAGING MEMBER
Phone 3525120092

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number ME112254
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MIDSTATE SKIN INSTITUTE, LLC CASH BALANCE PLAN 2023 454674459 2024-10-02 MIDSTATE SKIN INSTITUTE, LLC 47
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1630 SE 18TH ST #400, OCALA, FL, 34471
MIDSTATE SKIN INSTITUTE, LLC 401(K) PLAN 2023 454674459 2024-09-26 MIDSTATE SKIN INSTITUTE, LLC 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1740 SE 18TH ST #1102, OCALA, FL, 34471
MIDSTATE SKIN INSTITUTE, LLC 401(K) PLAN 2022 454674459 2023-09-13 MIDSTATE SKIN INSTITUTE, LLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1740 SE 18TH ST #1102, OCALA, FL, 34471
MIDSTATE SKIN INSTITUTE, LLC CASH BALANCE PLAN 2022 454674459 2023-09-29 MIDSTATE SKIN INSTITUTE, LLC 40
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1740 SE 18TH ST #1102, OCALA, FL, 34471
MIDSTATE SKIN INSTITUTE, LLC 401(K) PLAN 2021 454674459 2023-01-18 MIDSTATE SKIN INSTITUTE, LLC 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1740 SE 18TH ST #1102, OCALA, FL, 34471
MIDSTATE SKIN INSTITUTE, LLC CASH BALANCE PLAN 2021 454674459 2023-01-12 MIDSTATE SKIN INSTITUTE, LLC 32
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1740 SE 18TH ST #1102, OCALA, FL, 34471
MIDSTATE SKIN INSTITUTE, LLC 401(K) PLAN 2020 454674459 2021-10-12 MIDSTATE SKIN INSTITUTE, LLC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1630 SE 18TH STREET, SUITE 400, OCALA, FL, 344715441
MIDSTATE SKIN INSTITUTE, LLC CASH BALANCE PLAN 2020 454674459 2021-10-12 MIDSTATE SKIN INSTITUTE, LLC 30
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1630 SE 18TH STREET, SUITE 400, OCALA, FL, 344715441
MIDSTATE SKIN INSTITUTE, LLC CASH BALANCE PLAN 2020 454674459 2023-01-12 MIDSTATE SKIN INSTITUTE, LLC 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1630 SE 18TH STREET, SUITE 400, OCALA, FL, 344715441
MIDSTATE SKIN INSTITUTE, LLC 401(K) PLAN 2019 454674459 2020-10-12 MIDSTATE SKIN INSTITUTE, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 3525120092
Plan sponsor’s address 1630 SE 18TH STREET, SUITE 400, OCALA, FL, 344715441

Agent

Name Role Address
Cauthen Thomas Agent 1740 SE 18th St, Ocala, FL, 34471

Manager

Name Role Address
CAUTHEN ASHLEY Manager 1740 SE 18th St, Ocala, FL, 34471

Member

Name Role Address
Cauthen Thomas Member 1740 SE 18th St, Ocala, FL, 34471

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-04-23 1740 SE 18th St, #1102, Ocala, FL 34471 No data
CHANGE OF MAILING ADDRESS 2021-04-23 1740 SE 18th St, #1102, Ocala, FL 34471 No data
REGISTERED AGENT ADDRESS CHANGED 2021-04-23 1740 SE 18th St, #1102, Ocala, FL 34471 No data
REGISTERED AGENT NAME CHANGED 2013-04-25 Cauthen, Thomas No data

Debts

Document Number Status Case Number Name of Court Date of Entry Expiration Date Amount Due Plaintiff
J17000164246 TERMINATED 1000000738019 MARION 2017-03-16 2037-03-24 $ 8,005.04 STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1415 W US HIGHWAY 90 STE 115, LAKE CITY FL320556156

Documents

Name Date
ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2023-04-27
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-06-30
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-04-26
ANNUAL REPORT 2017-04-25
ANNUAL REPORT 2016-03-09
ANNUAL REPORT 2015-04-28

Related by officers

CAUTHEN ASHLEY

HYDRO SPORTING, LLC

Cauthen Thomas

MEDPARK CONDOMINIUM OWNERS' ASSOCIATION, INC. MIDSTATE PROPERTIES-JASMINE, LLC

Related by address

1740 SE 18th St, Ocala, FL, 34471, US

TRT FOR MEN LLC

1740 SE 18th St, Ocala, FL, 34471, US

TRT FOR MEN LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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