| Entity Name: | DAZZLING DERMATOLOGY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Mar 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Jul 2019 (6 years ago) |
| Document Number: | L19000063376 |
| FEI/EIN Number | 84-2092077 |
| Address: | 22029 State Rd 7, Ste 101, Boca Raton, FL 33428 |
| Mail Address: | 22029 State Rd 7, Ste 101, Boca Raton, FL 33428 |
| ZIP code: | 33428 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336752120 | 2020-08-31 | 2020-08-31 | 22029 STATE ROAD 7 STE 1, BOCA RATON, FL, 334284200, US | 22029 STATE ROAD 7 STE 1, BOCA RATON, FL, 334284200, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 561-923-0905 |
Authorized person
| Name | DR. ERIC W RUDNICK |
| Role | OWNER/DERMATOLOGIST |
| Phone | 5619230905 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAZZLING DERMATOLOGY RETIREMENT PLAN | 2023 | 842092077 | 2024-09-02 | DAZZLING DERMATOLOGY PLLC | 2 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-09-02 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-09-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5617159658 |
| Plan sponsor’s address | 22029 STATE RD 7 STE 101, BOCA RATON, FL, 33428 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-12 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| RUDNICK, ERIC W | Agent | 22029 State Rd 7, Ste 101, Boca Raton, FL 33428 |
| Name | Role | Address |
|---|---|---|
| RUDNICK, ERIC W | Managing Member | 22029 State Rd 7, Ste 101 Boca Raton, FL 33428 |
| Rudnick, Danielle A | Managing Member | 22029 State Rd 7, Ste 101 Boca Raton, FL 33428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-08 | 22029 State Rd 7, Ste 101, Boca Raton, FL 33428 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-08 | 22029 State Rd 7, Ste 101, Boca Raton, FL 33428 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-08 | 22029 State Rd 7, Ste 101, Boca Raton, FL 33428 | No data |
| LC AMENDMENT | 2019-07-10 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-01-19 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-12 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-01-25 |
| LC Amendment | 2019-07-10 |
| Florida Limited Liability | 2019-03-05 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
