| Entity Name: | WESLEY CHAPEL DERMATOLOGY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Jan 2015 (10 years ago) |
| Document Number: | L15000016587 |
| FEI/EIN Number | 47-2964847 |
| Address: | 2336 CRESTOVER LN, WESLEY CHAPEL, FL, 33544, US |
| Mail Address: | 2336 CRESTOVER LN, WESLEY CHAPEL, FL, 33544, US |
| ZIP code: | 33544 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407249998 | 2015-03-09 | 2023-05-22 | 2336 CRESTOVER LN STE 101, WESLEY CHAPEL, FL, 335446794, US | 2336 CRESTOVER LN STE 101, WESLEY CHAPEL, FL, 335446794, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 813-606-4144 |
| Fax | 8136661508 |
Authorized person
| Name | SUJATHA TADICHERLA |
| Role | PARTNER |
| Phone | 8136660488 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WESLEY CHAPEL DERMATOLOGY LLC | 2023 | 472964847 | 2024-07-20 | WESLEY CHAPEL DERMATOLOGY LLC | 5 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-07-20 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-10-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 8135499142 |
| Plan sponsor’s address | 2336 CRESTOVER LN, STE 101, WESLEY CHAPEL, FL, 33544 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-21 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| TADICHERLA PRASAD | Agent | 2336 CRESTOVER LN, WESLEY CHAPEL, FL, 33544 |
| Name | Role | Address |
|---|---|---|
| TADICHERLA SUJATHA | Managing Member | 2336 CRESTOVER LN, WESLEY CHAPEL, FL, 33544 |
| Name | Role | Address |
|---|---|---|
| TADICHERLA PRASAD | Manager | 2336 CRESTOVER LN, WESLEY CHAPEL, FL, 33544 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-06 | 2336 CRESTOVER LN, SUITE 101, WESLEY CHAPEL, FL 33544 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-06 | 2336 CRESTOVER LN, SUITE 101, WESLEY CHAPEL, FL 33544 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-06 | 2336 CRESTOVER LN, SUITE 101, WESLEY CHAPEL, FL 33544 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-28 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-03-06 |
| ANNUAL REPORT | 2021-03-29 |
| ANNUAL REPORT | 2020-02-26 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-29 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-29 |
| Florida Limited Liability | 2015-01-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
