| Entity Name: | CENTRAL FLORIDA DERMATOLOGY INSTITUTE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Jul 2018 (7 years ago) |
| Document Number: | L18000183909 |
| FEI/EIN Number | 83-1417592 |
| Address: | 5450 Land O Lakes Blvd, Land O Lakes, FL, 34639, US |
| Mail Address: | 15106 CONTOY PLACE, TAMPA, FL, 33618, US |
| ZIP code: | 34639 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720544380 | 2019-02-19 | 2020-08-16 | 5450 LAND O LAKES BLVD, LAND O LAKES, FL, 346393413, US | 5450 LAND O LAKES BLVD, LAND O LAKES, FL, 34639, US | |||||||||||||||
|
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| Phone | +1 813-553-5050 |
| Fax | 8135636353 |
Authorized person
| Name | GEORGE ALAN BRANT |
| Role | OWNER |
| Phone | 8135535050 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Brant George | Agent | 5450 Land O Lakes Blvd, Land O Lakes, FL, 34639 |
| Name | Role | Address |
|---|---|---|
| BRANT GEORGE | Manager | 15106 CONTOY PLACE, TAMPA, FL, 33618 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000024663 | CENTRAL FLORIDA DERMATOLOGY INSTITUTE | ACTIVE | 2020-02-25 | 2025-12-31 | No data | 5450 LAND O LAKES BLVD, LAND O LAKES, FL, 34629 |
| G19000059674 | FLORIDA DERMATOLOGY INSTITUTE | EXPIRED | 2019-05-20 | 2024-12-31 | No data | 15106 CONTOY PL, TAMPA, FL, 33618 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-02-24 | Brant, George | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-24 | 5450 Land O Lakes Blvd, Land O Lakes, FL 34639 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-01-10 | 5450 Land O Lakes Blvd, Land O Lakes, FL 34639 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-02-24 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-01-10 |
| Florida Limited Liability | 2018-07-31 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
