| Entity Name: | REVIVIFY DERMATOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
REVIVIFY DERMATOLOGY, 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. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 21 Oct 2019 (5 years ago) |
| Date of dissolution: | 24 Sep 2021 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (4 years ago) |
| Document Number: | L19000252534 |
| FEI/EIN Number |
84-2474824
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 21301 POWERLINE ROAD, BOCA RATON, FL, 33433, US |
| Mail Address: | 21301 POWERLINE ROAD, BOCA RATON, FL, 33433, US |
| ZIP code: | 33433 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699319988 | 2019-10-30 | 2020-08-19 | 21301 POWERLINE RD STE 108, BOCA RATON, FL, 334332388, US | 21301 POWERLINE RD # 108, BOCA RATON, FL, 334332388, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 561-877-8675 |
| Fax | 5616721365 |
Authorized person
| Name | DENISE M. GUEVARA |
| Role | MEDICAL DIRECTOR |
| Phone | 5618778675 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REVIVIFY DERMATOLOGY LLC 401(K) PROFIT SHARING PLAN & TRUST | 2023 | 842474824 | 2024-06-07 | REVIVIFY DERMATOLOGY LLC | 0 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-06-07 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9547297917 |
| Plan sponsor’s address | 21301 POWERLINE RD STE 108, BOCA RATON, FL, 33433 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-27 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9547297917 |
| Plan sponsor’s address | 21301 POWERLINE RD STE 108, BOCA RATON, FL, 33433 |
Signature of
| Role | Plan administrator |
| Date | 2022-09-13 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 9547297917 |
| Plan sponsor’s address | 21301 POWERLINE RD STE 108, BOCA RATON, FL, 33433 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-19 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| CANES EIGHTEEN, LLC | Manager |
| ABN LAW, PLLC | Agent |
| DENISE GUEVARA, D.O., P.A. | Manager |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000088131 | REVIVIFY DERMATOLOGY | ACTIVE | 2020-07-24 | 2025-12-31 | - | 21301 POWERLINE ROAD, SUITE 108, BOCA RATON, FL, 33433 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-25 | 21301 POWERLINE ROAD, SUITE 108, BOCA RATON, FL 33433 | - |
| CHANGE OF MAILING ADDRESS | 2020-03-25 | 21301 POWERLINE ROAD, SUITE 108, BOCA RATON, FL 33433 | - |
| REGISTERED AGENT NAME CHANGED | 2020-03-25 | ABN LAW, PLLC | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-25 | 2390 TAMIAMI TRAIL N, SUITE 214, NAPLES, FL 34103 | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J22000263261 | TERMINATED | 1000000922312 | PALM BEACH | 2022-05-04 | 2032-06-01 | $ 675.69 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-03-25 |
| Florida Limited Liability | 2019-10-21 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
