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NORTH FLORIDA DERMATOLOGY, LLC - Florida Company Profile

Company Details

Entity Name: NORTH FLORIDA DERMATOLOGY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

NORTH FLORIDA 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.
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: 08 Mar 2016 (9 years ago)
Document Number: L16000048124
FEI/EIN Number 81-1690095

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

Address: 1722 SW NEWLAND WAY, LAKE CITY, FL, 32025, US
Mail Address: 1722 SW NEWLAND WAY, LAKE CITY, FL, 32025, US
ZIP code: 32025
County: Columbia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1689023830 2016-06-08 2024-03-07 PO BOX 530033, ATLANTA, GA, 303530033, US 1722 SW NEWLAND WAY, LAKE CITY, FL, 320256915, US

Contacts

Phone +1 386-344-6102
Fax 3863446103

Authorized person

Name KELLY TEPEDINO
Role OWNER
Phone 3863446102

Taxonomy

Taxonomy Code 207N00000X - Dermatology Physician
License Number ME122956
State FL
Is Primary Yes

Key Officers & Management

Name Role Address
TEPEDINO KELLY DMD Manager 1722 SW NEWLAND WAY, LAKE CITY, FL, 32025
CORTES JOSE HJR Agent 4 SE BROADWAY STREET, OCALA, FL, 34471

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2022-04-27 1722 SW NEWLAND WAY, LAKE CITY, FL 32025 -
CHANGE OF MAILING ADDRESS 2022-04-27 1722 SW NEWLAND WAY, LAKE CITY, FL 32025 -

Documents

Name Date
ANNUAL REPORT 2024-01-16
ANNUAL REPORT 2023-01-25
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-05-02
ANNUAL REPORT 2020-01-21
ANNUAL REPORT 2019-03-11
ANNUAL REPORT 2018-03-29
ANNUAL REPORT 2017-04-28
Florida Limited Liability 2016-03-08

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9924237005 2020-04-09 0491 PPP 1717 SW Newland Way, Lake City, FL, 32025-6966
Loan Status Date 2021-03-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 42968
Loan Approval Amount (current) 42968
Undisbursed Amount 0
Franchise Name -
Lender Location ID 124053
Servicing Lender Name Millennium Bank
Servicing Lender Address 6392 Artesian Cir, OOLTEWAH, TN, 37363-7295
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Lake City, COLUMBIA, FL, 32025-6966
Project Congressional District FL-03
Number of Employees 6
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 17221
Originating Lender Name Millennium Bank
Originating Lender Address Lake City, FL
Gender Unanswered
Veteran Non-Veteran
Forgiveness Amount 43345.16
Forgiveness Paid Date 2021-03-03

Date of last update: 02 Apr 2025

Sources: Florida Department of State