| Entity Name: | DERMATOLOGIST LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Dec 2021 (3 years ago) |
| Document Number: | L21000509578 |
| FEI/EIN Number | 87-3976394 |
| Address: | 13638 W. HILLSBOROUGH AVE., TAMPA, FL, 33635 |
| Mail Address: | 37045 CHAGRIN BLVD, MORELAND HILLS, OH, 44022, US |
| ZIP code: | 33635 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336899061 | 2022-03-25 | 2022-03-25 | 37045 CHAGRIN BLVD, MORELAND HILLS, OH, 440221238, US | 13638 W HILLSBOROUGH AVE, TAMPA, FL, 336359638, US | |||||||||||||||||||||
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| Phone | +1 216-280-1343 |
| Fax | 2167584783 |
| Phone | +1 440-804-5996 |
Authorized person
| Name | DR. OLGA DEMIDOVA |
| Role | DIRECTOR |
| Phone | 2162801343 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DEMIDOVA Olga Dr. | Agent | 189 HAGUE CT., SPRING HILL, FL, 34606 |
| Name | Role | Address |
|---|---|---|
| DEMIDOVA OLGA V | Manager | 37045 CHAGRIN BLVD, MORELAND HILLS, OH, 44022 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-01-27 | DEMIDOVA, Olga, Dr. | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-06 | 13638 W. HILLSBOROUGH AVE., TAMPA, FL 33635 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-03-06 |
| Florida Limited Liability | 2021-12-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
