| Entity Name: | EXQUISITE DERMATOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 27 Jan 2016 (9 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L16000018789 |
| FEI/EIN Number | 81-1287096 |
| Address: | 12315 LAKE UNDERHILL ROAD, ORLANDO, FL 32828 |
| Mail Address: | 12315 LAKE UNDERHILL ROAD, ORLANDO, FL 32828 |
| ZIP code: | 32828 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053779223 | 2016-02-03 | 2016-05-04 | 12315 LAKE UNDERHILL RD, ORLANDO, FL, 328284507, US | 12315 LAKE UNDERHILL RD, ORLANDO, FL, 328284507, US | |||||||||||||||||||
|
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| Phone | +1 407-403-5620 |
| Fax | 4074125920 |
Authorized person
| Name | MRS. LOUISE M CLINGMAN |
| Role | OFFICE MANAGER |
| Phone | 4074595213 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | ME109349 |
| State | DE |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WALKER, GARY | Agent | 401 E Jackson Street, Suite 3100, TAMPA, FL 33602 |
| Name | Role | Address |
|---|---|---|
| BICHARA, JOSE | Manager | 12315 LAKE UNDERHILL ROAD, ORLANDO, FL 32828 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 401 E Jackson Street, Suite 3100, TAMPA, FL 33602 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-28 |
| Florida Limited Liability | 2016-01-27 |
Date of last update: 20 Jan 2025
Sources: Florida Department of State
