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  5. MIDSTATE SKIN INSTITUTE, LLC

MIDSTATE SKIN INSTITUTE, LLC - Florida Company Profile

Company Details

Entity Name: MIDSTATE SKIN INSTITUTE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

MIDSTATE SKIN INSTITUTE, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 24 Feb 2012 (13 years ago)
Document Number: L12000026981
FEI/EIN Number 454674459

Federal Employer Identification (FEI) Number assigned by the IRS.
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 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 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 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

Key Officers & Management

Name Role Address
CAUTHEN ASHLEY Manager 1740 SE 18th St, Ocala, FL, 34471
Cauthen Thomas Member 1740 SE 18th St, Ocala, FL, 34471
Cauthen Thomas Agent 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 -
CHANGE OF MAILING ADDRESS 2021-04-23 1740 SE 18th St, #1102, Ocala, FL 34471 -
REGISTERED AGENT ADDRESS CHANGED 2021-04-23 1740 SE 18th St, #1102, Ocala, FL 34471 -
REGISTERED AGENT NAME CHANGED 2013-04-25 Cauthen, Thomas -

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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5218197000 2020-04-05 0491 PPP 1630 SE 18TH ST #400, OCALA, FL, 34471-5409
Loan Status Date 2021-07-15
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 441600
Loan Approval Amount (current) 441600
Undisbursed Amount 0
Franchise Name -
Lender Location ID 40010
Servicing Lender Name Renasant Bank
Servicing Lender Address 209 Troy St, TUPELO, MS, 38804-4827
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address OCALA, MARION, FL, 34471-5409
Project Congressional District FL-03
Number of Employees 41
NAICS code 621111
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 40010
Originating Lender Name Renasant Bank
Originating Lender Address TUPELO, MS
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 446862.4
Forgiveness Paid Date 2021-06-24

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Date of last update: 01 Apr 2025

Sources: Florida Department of State

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