| Entity Name: | BEAL DERMATOLOGY, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Feb 2020 (5 years ago) |
| Document Number: | L20000039477 |
| FEI/EIN Number | 84-4804195 |
| Address: | 6817 SOUTHPOINT PKWY, SUITE 101, JACKSONVILLE, FL 32216 |
| Mail Address: | 6817 SOUTHPOINT PKWY, SUITE 101, JACKSONVILLE, FL 32216 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841825791 | 2020-03-10 | 2024-08-06 | 6817 SOUTHPOINT PKWY STE 101, JACKSONVILLE, FL, 322166285, US | 6817 SOUTHPOINT PKWY STE 101, JACKSONVILLE, FL, 322166285, US | |||||||||||||||||||||||||||||||
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| Phone | +1 904-420-7372 |
| Fax | 9049149231 |
Authorized person
| Name | BRANDON T BEAL |
| Role | MANAGER |
| Phone | 3144226882 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| Is Primary | No |
| Taxonomy Code | 207NP0225X - Pediatric Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| HAYMAN, STEPHEN D, ESQ | Agent | 6605 GUNN HIGHWAY TAMPA, TAMPA, FL 33625 |
| Name | Role | Address |
|---|---|---|
| BEAL, BRANDON T | Manager | 6817 Southpoint Pwky, STE 101 JACKSONVILLE 32216 UN |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000079191 | JACKSONVILLE SKIN CANCER SPECIALISTS | ACTIVE | 2020-07-07 | 2025-12-31 | No data | 6817 SOUTHPOINT PKWY, SUITE 101, JACKSONVILLE, FL, 32216 |
| G20000079195 | JACKSONVILLE DERMATOLOGY & COSMETIC SURGERY | ACTIVE | 2020-07-07 | 2025-12-31 | No data | 6817 SOUTHPOINT PKWY, SUITE 101, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-07-17 | 6817 SOUTHPOINT PKWY, SUITE 101, JACKSONVILLE, FL 32216 | No data |
| CHANGE OF MAILING ADDRESS | 2020-07-17 | 6817 SOUTHPOINT PKWY, SUITE 101, JACKSONVILLE, FL 32216 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-12 |
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-02-25 |
| Florida Limited Liability | 2020-02-03 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
