| Entity Name: | DELRAY DERMATOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Jan 2017 (8 years ago) |
| Document Number: | L17000010847 |
| FEI/EIN Number | 814964667 |
| Address: | 550 SE 6th Avenue, Suite 100, Delray Beach, FL, 33483, US |
| Mail Address: | 550 SE 6th Avenue, Suite 100, Delray Beach, FL, 33483, US |
| ZIP code: | 33483 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538695168 | 2017-05-02 | 2020-09-28 | 550 SE 6TH AVE, STE 100, DELRAY BEACH, FL, 334835252, US | 550 SE 6TH AVE, SUITE 100, DELRAY BEACH, FL, 334835252, US | |||||||||||||||||||||||||
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| Phone | +1 561-440-8020 |
| Fax | 5614408222 |
| Fax | 5614408020 |
Authorized person
| Name | FRANCESCA LEWIS |
| Role | OWNER |
| Phone | 8438199907 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DELRAY DERMATOLOGY LLC 401(K) PL | 2023 | 814964667 | 2024-05-29 | DELRAY DERMATOLOGY, LLC | 34 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-05-29 |
| Name of individual signing | JENNIFER USHER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-02-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3524220482 |
| Plan sponsor’s address | 550 SE 6TH AVE, STE 100, DELRAY BEACH, FL, 33483 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-05 |
| Name of individual signing | JENNIFER USHER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| LEWIS FRANCESCA | Agent | 550 SE 6th Avenue, Delray Beach, FL, 33483 |
| Name | Role | Address |
|---|---|---|
| Lewis Alex | Auth | 550 SE 6th Avenue, Delray Beach, FL, 33483 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000105706 | DELRAY DERMATOLOGY + COSMETIC CENTER | ACTIVE | 2017-09-24 | 2027-12-31 | No data | 550 SE 6TH AVENUE, SUITE 100, DELRAY BEACH, FL, 33483 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-13 | 550 SE 6th Avenue, Suite 100, Delray Beach, FL 33483 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-12 | 550 SE 6th Avenue, Suite 100, Delray Beach, FL 33483 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-12 | 550 SE 6th Avenue, Suite 100, Delray Beach, FL 33483 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-12 |
| Florida Limited Liability | 2017-01-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
