| Entity Name: | SUN DERMATOLOGY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 May 2016 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 06 Sep 2018 (6 years ago) |
| Document Number: | L16000087770 |
| FEI/EIN Number | 81-2652370 |
| Address: | 2101 Jenks Ave, Panama City, FL, 32405, US |
| Mail Address: | 2101 Jenks Ave, PANAMA CITY, FL, 32405, US |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407207111 | 2016-06-23 | 2016-06-23 | 2101 JENKS AVE, PANAMA CITY, FL, 324054511, US | 2101 JENKS AVE, PANAMA CITY, FL, 324054511, US | |||||||||||||||||
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| Phone | +1 334-791-5423 |
Authorized person
| Name | LEONARD TERRY PYNES |
| Role | AUTHORIZED MEMBER |
| Phone | 3347915423 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUN DERMATOLOGY 401K PLAN | 2023 | 812652370 | 2024-05-29 | SUN DERMATOLOGY | 11 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-05-29 |
| Name of individual signing | JENNIFER SUNSERI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4088918353 |
| Plan sponsor’s address | 2101 JENKS AVE, PANAMA CITY, FL, 32405 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-20 |
| Name of individual signing | JENNIFER SUNSERI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4088918353 |
| Plan sponsor’s address | 2101 JENKS AVE, PANAMA CITY, FL, 32405 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-20 |
| Name of individual signing | JENNIFER SUNSERI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4088918353 |
| Plan sponsor’s address | 2101 JENKS AVE, PANAMA CITY, FL, 32405 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-20 |
| Name of individual signing | JENNIFER SUNSERI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Sunseri Jeremy ADr. | Agent | 2101 Jenks Ave, Panama City, FL, 32405 |
| Name | Role | Address |
|---|---|---|
| SUNSERI JEREMY | Authorized Member | 1411 TROUT DR., PANAMA CITY, FL, 32408 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000048446 | SUN DERMATOLOGY | ACTIVE | 2018-04-16 | 2028-12-31 | No data | 2101 JENKS AVE, PANAMA CITY, FL, 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2018-09-06 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-03-26 | Sunseri, Jeremy Alexander, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-03-26 | 2101 Jenks Ave, Panama City, FL 32405 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-10 | 2101 Jenks Ave, Panama City, FL 32405 | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-10 | 2101 Jenks Ave, Panama City, FL 32405 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-05 |
| LC Amendment | 2018-09-06 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-10 |
| Florida Limited Liability | 2016-05-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
