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ORLANDO DERMATOLOGY CLINIC, LLC - Florida Company Profile

Company Details

Entity Name: ORLANDO DERMATOLOGY CLINIC, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

ORLANDO DERMATOLOGY CLINIC, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 28 Dec 2018 (6 years ago)
Document Number: L18000292384
FEI/EIN Number 83-2905038

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 1040 Lake Sumter Landing, The Villages, FL, 32162, US
Mail Address: 1040 Lake Sumter Landing, The Villages, FL, 32162, US
ZIP code: 32162
County: Sumter
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1669251112 2023-09-25 2024-02-01 1040 LAKE SUMTER LNDG, THE VILLAGES, FL, 321622697, US 118 W ORANGE ST, ALTAMONTE SPRINGS, FL, 327142537, US

Contacts

Phone +1 352-218-3211

Authorized person

Name TAREK S SHAATH
Role MD
Phone 3522183211

Taxonomy

Taxonomy Code 207N00000X - Dermatology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CARE DERMATOLOGY AND SKIN CANCER CENTERS 401(K) PLAN 2023 832905038 2024-05-22 ORLANDO DERMATOLOGY CLINIC LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2023-01-01
Business code 621111
Sponsor’s telephone number 3522183211
Plan sponsor’s address 1040 LAKE SUMTER LANDING, THE VILLAGES, FL, 32162

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2024-05-22
Name of individual signing QIAN LIU
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
SHAATH TAREK S President 1040 Lake Sumter Landing, The Villages, FL, 32162
SHAATH TAREK S Agent 1040 Lake Sumter Landing, The Villages, FL, 32162

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000044672 CARE DERMATOLOGY AND SKIN CANCER CENTERS ACTIVE 2020-04-23 2025-12-31 - 1040 LAKE SUMTER LANDING, THE VILLAGES, FL, 32162

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2021-03-15 SHAATH, TAREK S -
CHANGE OF PRINCIPAL ADDRESS 2020-04-23 1040 Lake Sumter Landing, The Villages, FL 32162 -
CHANGE OF MAILING ADDRESS 2020-04-23 1040 Lake Sumter Landing, The Villages, FL 32162 -
REGISTERED AGENT ADDRESS CHANGED 2020-04-23 1040 Lake Sumter Landing, The Villages, FL 32162 -

Documents

Name Date
ANNUAL REPORT 2025-01-13
ANNUAL REPORT 2024-02-02
ANNUAL REPORT 2023-01-26
ANNUAL REPORT 2022-03-07
ANNUAL REPORT 2021-03-15
ANNUAL REPORT 2020-04-23
Florida Limited Liability 2018-12-28

Date of last update: 02 Apr 2025

Sources: Florida Department of State