| Entity Name: | PINE ISLAND DERMATOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Dec 2019 (5 years ago) |
| Document Number: | L20000003375 |
| FEI/EIN Number | 84-4252827 |
| Address: | 3365 Burns Rd, Suite 217, Palm Beach Gardens, FL 33410 |
| Mail Address: | 3365 Burns Rd, Suite 217, Palm Beach Gardens, FL 33410 |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508580200 | 2022-09-27 | 2022-09-27 | 9118A SW 20TH CT, DAVIE, FL, 333245074, US | 3365 BURNS RD STE 217, PALM BEACH GARDENS, FL, 334104312, US | |||||||||||||
|
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| Phone | +1 772-485-5574 |
Authorized person
| Name | DR. SERGEY ARUTYUNYAN |
| Role | DERMATOLOGIST/PRESIDENT |
| Phone | 7724855574 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ARUTYUNYAN, SERGEY | Agent | 9118A SW 20TH CT., DAVIE, FL 33324 |
| Name | Role | Address |
|---|---|---|
| ARUTYUNYAN, SERGEY | Authorized Member | 9118A SW 20TH CT., DAVIE, FL 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-17 | 3365 Burns Rd, Suite 217, Palm Beach Gardens, FL 33410 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-17 | 3365 Burns Rd, Suite 217, Palm Beach Gardens, FL 33410 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-14 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-29 |
| Florida Limited Liability | 2019-12-23 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
