| Entity Name: | NUPLO DERMATOLOGY, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Sep 2021 (3 years ago) |
| Document Number: | L21000403375 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 718 LAKEVIEW RD., CLEARWATER, FL, 33756, US |
| Mail Address: | 718 LAKEVIEW RD., CLEARWATER, FL, 33756, US |
| ZIP code: | 33756 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033879416 | 2021-12-27 | 2021-12-29 | 718 LAKEVIEW RD STE B, CLEARWATER, FL, 337563460, US | 718 LAKEVIEW RD STE B, CLEARWATER, FL, 337563460, US | |||||||||||||
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| Phone | +1 727-447-1229 |
Authorized person
| Name | DR. LAUREN METTERLE |
| Role | MANAGING PARTNER |
| Phone | 8137854861 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NUPLO DERMATOLOGY, L.L.C. 401K PLAN | 2023 | 872620561 | 2024-08-30 | NUPLO DERMATOLOGY, L.L.C. | 5 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 621874769 |
| Plan administrator’s name | ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2024-08-30 |
| Name of individual signing | TARA EVANS, FOR TAG RESOURCES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3302895186 |
| Plan sponsor’s address | 718 LAKEVIEW ROAD SUITE B, CLEARWATER, FL, 33756 |
Plan administrator’s name and address
| Administrator’s EIN | 621874769 |
| Plan administrator’s name | ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES |
| Plan administrator’s address | 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919 |
| Administrator’s telephone number | 8656701844 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-06 |
| Name of individual signing | TARA EVANS, FOR TAG RESOURCES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GASSMAN ALAN SESQ. | Agent | 1245 COURT STREET, CLEARWATER, FL, 33756 |
| Name | Role | Address |
|---|---|---|
| PATEL NUPUR | Manager | 1245 COURT STREET, CLEARWATER, FL, 33756 |
| METTERLE LAUREN | Manager | 1245 COURT STREET, CLEARWATER, FL, 33756 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000060137 | LUMA DERMATOLOGY | ACTIVE | 2022-05-12 | 2027-12-31 | No data | 718 LAKEVIEW RD., CLEARWATER, FL, 33756 |
| G22000005506 | DERMATOLOGY ESTHETICA | ACTIVE | 2022-01-14 | 2027-12-31 | No data | 718 LAKEVIEW RD, CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-25 | 718 LAKEVIEW RD., CLEARWATER, FL 33756 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-25 | 718 LAKEVIEW RD., CLEARWATER, FL 33756 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| ANNUAL REPORT | 2023-01-12 |
| ANNUAL REPORT | 2022-01-25 |
| Florida Limited Liability | 2021-09-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
