| Entity Name: | OCEANS DERMATOLOGY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Jan 2018 (7 years ago) |
| Document Number: | L18000009292 |
| FEI/EIN Number | 83-0911380 |
| Address: | 10151 ENTERPRISE CENTER BLVD, SUITE 204, BOYNTON BEACH, FL, 33437 |
| Mail Address: | 10151 ENTERPRISE CENTER BLVD, SUITE 204, BOYNTON BEACH, FL, 33437 |
| ZIP code: | 33437 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013401710 | 2018-06-18 | 2020-08-27 | 10151 ENTERPRISE CENTER BLVD, SUITE 204, BOYNTON BEACH, FL, 334373761, US | 10151 ENTERPRISE CENTER BLVD, SUITE 204, BOYNTON BEACH, FL, 334373761, US | |||||||||||||||||||||||||||||
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| Phone | +1 561-405-3000 |
| Fax | 5614591444 |
| Phone | +1 561-235-4222 |
| Fax | 5617378583 |
Authorized person
| Name | TEO D DAMSE |
| Role | CEO |
| Phone | 5614053000 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | VLXSP |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DAMSE THEO D | Agent | 199 OREGON LANE, BOCA RATON, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| DAMSE THEO D | Manager | 199 OREGON LANE, BOCA RATON, FL, 33487 |
| Name | Role | Address |
|---|---|---|
| DAMSE AMELIA G | Authorized Member | 199 OREGON LANE, BOCA RATON, FL, 33487 |
| GHERGHINA ANDREI P | Authorized Member | 105 OREGON LANE, BOCA RATON, FL, 33487 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-10 | DAMSE, THEO DANIEL | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| ANNUAL REPORT | 2023-03-16 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2019-02-06 |
| Florida Limited Liability | 2018-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
