Entity Name: | THEO MEDICAL DERMATOLOGY, LLC |
Jurisdiction: | FLORIDA |
Filing Type: |
Florida Limited Liability Co.
THEO MEDICAL DERMATOLOGY, 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. |
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: | 30 Jan 2013 (12 years ago) |
Last Event: | LC AMENDMENT AND NAME CHANGE |
Event Date Filed: | 21 May 2013 (12 years ago) |
Document Number: | L13000016096 |
FEI/EIN Number |
46-1920858
Federal Employer Identification (FEI) Number assigned by the IRS. |
Address: | 3030 E. Semoran Blvd, Apopka, FL, 32703, US |
Mail Address: | 3030 E SEMORAN BLVD, APOPKA, FL, 32703, US |
ZIP code: | 32703 |
County: | Orange |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1558707588 | 2013-05-16 | 2024-06-04 | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 327035900, US | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 327035900, US | |||||||||||||||||||||||||
|
Phone | +1 407-671-3634 |
Fax | 4079866033 |
Authorized person
Name | ATHENA THEODOSATOS |
Role | OWNER |
Phone | 4076713634 |
Taxonomy
Taxonomy Code | 207N00000X - Dermatology Physician |
License Number | OS38457 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 001101800 |
State | FL |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
THEO MEDICAL DERMATOLOGY LLC 401(K) PROFIT SHARING PLAN & TRUST | 2022 | 461920858 | 2023-10-09 | THEO MEDICAL DERMATOLOGY LLC | 6 | |||||||||||||||||||||||
|
Role | Plan administrator |
Date | 2023-10-09 |
Name of individual signing | MILETA THEODOSAT |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 621330 |
Sponsor’s telephone number | 4076713634 |
Plan sponsor’s address | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 60642 |
Signature of
Role | Plan administrator |
Date | 2023-10-09 |
Name of individual signing | MILETA THEODOSAT |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 621330 |
Sponsor’s telephone number | 4076713634 |
Plan sponsor’s address | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 32703 |
Signature of
Role | Plan administrator |
Date | 2023-10-09 |
Name of individual signing | MILETA THEODOSAT |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 621330 |
Sponsor’s telephone number | 4076713634 |
Plan sponsor’s address | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 32703 |
Signature of
Role | Plan administrator |
Date | 2023-10-04 |
Name of individual signing | MILETA THEODOSAT |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 621330 |
Sponsor’s telephone number | 4076713634 |
Plan sponsor’s address | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 32703 |
Signature of
Role | Plan administrator |
Date | 2023-10-09 |
Name of individual signing | MILETA THEODOSAT |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 621330 |
Sponsor’s telephone number | 4076713634 |
Plan sponsor’s address | 3030 E SEMORAN BLVD STE 258, APOPKA, FL, 32703 |
Signature of
Role | Plan administrator |
Date | 2021-08-11 |
Name of individual signing | PAUL NEUMAN |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role | Address |
---|---|---|
THEODOSATOS ATHENA DO, MPH | Manager | 3030 E SEMORAN BLVD, APOPKA, FL, 32703 |
NEUMAN PAUL E | Manager | 3030 E SEMORAN BLVD, APOPKA, FL, 32703 |
NEUMAN PAUL E | Agent | 3030 E. Semoran Blvd, Apopka, FL, 32703 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF MAILING ADDRESS | 2018-02-21 | 3030 E. Semoran Blvd, Suite 258, Apopka, FL 32703 | - |
CHANGE OF PRINCIPAL ADDRESS | 2017-02-02 | 3030 E. Semoran Blvd, Suite 258, Apopka, FL 32703 | - |
REGISTERED AGENT ADDRESS CHANGED | 2017-02-02 | 3030 E. Semoran Blvd, Suite 258, Apopka, FL 32703 | - |
REGISTERED AGENT NAME CHANGED | 2015-04-28 | NEUMAN, PAUL ELMER | - |
LC AMENDMENT AND NAME CHANGE | 2013-05-21 | THEO MEDICAL DERMATOLOGY, LLC | - |
Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
---|---|---|---|---|---|---|---|
J17000549669 | LAPSED | CACE17017937 | 17TH CIRCUIT BROWARD COUNTY | 2017-06-29 | 2022-10-09 | $15,876.86 | DE LAGE LANDEN, 1111 OLD EAGLE SCHOOL ROAD, WAYNE, PA |
Name | Date |
---|---|
ANNUAL REPORT | 2024-02-12 |
ANNUAL REPORT | 2023-04-08 |
ANNUAL REPORT | 2022-03-28 |
ANNUAL REPORT | 2021-02-13 |
ANNUAL REPORT | 2020-02-20 |
ANNUAL REPORT | 2019-04-25 |
ANNUAL REPORT | 2018-02-21 |
ANNUAL REPORT | 2017-02-02 |
ANNUAL REPORT | 2016-03-30 |
ANNUAL REPORT | 2015-04-28 |
Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2619697408 | 2020-05-06 | 0491 | PPP | 3030 SEMORAN BLVD, APOPKA, FL, 32703 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 May 2025
Sources: Florida Department of State