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STATE WIDE DERMATOLOGY "LLC" - Florida Company Profile

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Company Details

Entity Name: STATE WIDE DERMATOLOGY "LLC"
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 12 Apr 2012 (13 years ago)
Document Number: L12000050534
FEI/EIN Number 45-2561811
Address: 17121 RAINBOW TERRACE, ODESSA, FL, 33556
Mail Address: 17121 RAINBOW TERRACE, ODESSA, FL, 33556
ZIP code: 33556
City: Odessa
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Harrell Cecil R Managing Member 17121 RAINBOW TERRACE, ODESSA, FL, 33556
Harrell Kathleen Y Managing Member 17121 RAINBOW TERRACE, ODESSA, FL, 33556
Harrell Kristinia M Manager 17121 RAINBOW TERRACE, ODESSA, FL, 33556
Harrell Cecil W Manager 12948 Royal Georage Ave, Odessa, FL, 33556
HARRELL CECIL R Agent 17121 RAINBOW TERRACE, ODESSA, FL, 33556

National Provider Identifier

NPI Number:
1427473073

Authorized Person:

Name:
MRS. KATHLEEN Y HARRELL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
8134757831

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000075672 ONLY DERM EXPIRED 2014-07-22 2019-12-31 - 17121 RAINBOW TERRACE, ODESSA, FL, 33556

Documents

Name Date
ANNUAL REPORT 2025-01-20
ANNUAL REPORT 2024-01-04
ANNUAL REPORT 2023-03-14
ANNUAL REPORT 2022-02-25
ANNUAL REPORT 2021-01-04
ANNUAL REPORT 2020-03-24
ANNUAL REPORT 2019-06-13
ANNUAL REPORT 2018-01-17
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-01-27

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$49,180
Date Approved:
2021-03-23
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$49,180
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$49,420.44
Servicing Lender:
Fifth Third Bank
Use of Proceeds:
Payroll: $49,180
Jobs Reported:
8
Initial Approval Amount:
$51,865
Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$51,865
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$52,596.87
Servicing Lender:
Fifth Third Bank
Use of Proceeds:
Payroll: $51,865

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Date of last update: 02 Aug 2025

Sources: Florida Department of State