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  5. ST. PETERSBURG DERMATOLOGY LLC

ST. PETERSBURG DERMATOLOGY LLC

Company Details

Entity Name: ST. PETERSBURG DERMATOLOGY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 30 Jun 2016 (9 years ago)
Document Number: L16000125529
FEI/EIN Number 813255800
Address: 1530 DR. MLK JR. ST. N, ST. PETERSBURG, FL, 33704, US
Mail Address: 446 18TH AVE NE, ST. PETERSBURG, FL, 33704, US
ZIP code: 33704
County: Pinellas
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205381175 2016-08-22 2017-03-11 1530 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL, 337044202, US 1530 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL, 337044202, US

Contacts
Phone +1 727-202-9442
Fax 7272652507

Authorized person
Name ELIZABETH ARRINGTON
Role OWNER
Phone 7272029442

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number ME109267
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ST. PETERSBURG DERMATOLOGY LLC 401(K) PLAN 2023 813255800 2024-10-10 ST. PETERSBURG DERMATOLOGY LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 7277352902
Plan sponsor’s address 1530 DR. MLK JR ST, N, ST. PETERSBURG, FL, 33704

Plan administrator’s name and address
Administrator’s EIN 823719843
Plan administrator’s name FUTUREPLAN FIDUCIARY SERVICES LLC
Plan administrator’s address PO BOX 55757, BOSTON, MA, 02205
Administrator’s telephone number 8557115283

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing GINA FLORA
Valid signature Filed with authorized/valid electronic signature
ST. PETERSBURG DERMATOLOGY LLC CASH BALANCE PENSION PLAN 2023 813255800 2024-10-15 ST. PETERSBURG DERMATOLOGY LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 7272029442
Plan sponsor’s address 1530 DR. MLK JR. ST. N., ST. PETERSBURG, FL, 33704

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing ELIZABETH ARRINGTON
Valid signature Filed with authorized/valid electronic signature
ST. PETERSBURG DERMATOLOGY LLC CASH BALANCE PENSION PLAN 2022 813255800 2023-09-12 ST. PETERSBURG DERMATOLOGY LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 7272029442
Plan sponsor’s address 1530 DR. MLK JR. ST. N., ST. PETERSBURG, FL, 33704

Signature of
Role Plan administrator
Date 2023-09-12
Name of individual signing ELIZABETH ARRINGTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-12
Name of individual signing ELIZABETH ARRINGTON
Valid signature Filed with authorized/valid electronic signature
ST. PETERSBURG DERMATOLOGY LLC 401(K) PLAN 2022 813255800 2023-09-05 ST. PETERSBURG DERMATOLOGY LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 7272029442
Plan sponsor’s address 1530 DR. MLK JR STREET, NORTH, ST. PETERSBURG, FL, 33704

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing ELIZABETH ARRINGTON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-05
Name of individual signing ELIZABETH ARRINGTON
Valid signature Filed with authorized/valid electronic signature
ST. PETERSBURG DERMATOLOGY LLC CASH BALANCE PENSION PLAN 2021 813255800 2023-02-15 ST. PETERSBURG DERMATOLOGY, LLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 7272029442
Plan sponsor’s address 1530 DR. MLK JR ST. N, ST. PETERSBURG, FL, 33704
ST. PETERSBURG DERMATOLOGY LLC 401(K) PLAN 2021 813255800 2023-02-15 ST. PETERSBURG DERMATOLOGY LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621399
Sponsor’s telephone number 7272029442
Plan sponsor’s address 1530 DR. MLK JR STREET, NORTH, ST. PETERSBURG, FL, 33704

Agent

Name Role Address
ARRINGTON ROBERT Agent 446 18TH AVE NE, ST. PETERSBURG, FL, 33704

Manager

Name Role Address
ARRINGTON ROBERT Manager 446 18TH AVE NE, ST. PETERSBURG, FL, 33704

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G16000073384 ST.PETERSBURG DERMATOLOGY ACTIVE 2016-07-25 2026-12-31 No data 1530 DR. MLK JR. ST. N, ST. PETERSBURG, FL, 33704

Documents

Name Date
ANNUAL REPORT 2024-01-24
ANNUAL REPORT 2023-02-01
ANNUAL REPORT 2022-01-27
ANNUAL REPORT 2021-01-14
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-03-06
ANNUAL REPORT 2018-01-15
ANNUAL REPORT 2017-01-19
Florida Limited Liability 2016-06-30

Related by officers

ARRINGTON ROBERT

TIDEWATER REAL ESTATE LLC ARRINGTON DEVELOPMENT LLC ROMANO BROTHERS CONSTRUCTION, LLC

Related by address

No related companies by address

Date of last update: 03 Feb 2025

Sources: Florida Department of State

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