| Entity Name: | INSTITUTE OF DERMATOLOGY & OCULOPLASTIC SURGERY PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Feb 2022 (3 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Jul 2024 (7 months ago) |
| Document Number: | L22000085740 |
| FEI/EIN Number | 88-0822543 |
| Address: | 1617 S. Tuttle Ave,, ste 3, Sarasota, FL 34239 |
| Mail Address: | 1617 S. Tuttle Ave,, ste 3, Sarasota, FL 34239 |
| ZIP code: | 34239 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164165296 | 2022-04-17 | 2023-10-10 | PO BOX 15853, SARASOTA, FL, 342771853, US | 1617 S TUTTLE AVE FL 3, SARASOTA, FL, 342393132, US | |||||||||||||||||||||||||||
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| Phone | +1 941-499-0199 |
| Fax | 9412004021 |
Authorized person
| Name | ILYA LIM |
| Role | CO-OWNER |
| Phone | 9414990199 |
Taxonomy
| Taxonomy Code | 207NP0225X - Pediatric Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| Is Primary | No |
| Taxonomy Code | 207WX0200X - Ophthalmic Plastic and Reconstructive Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 261QX0200X - Oncology Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LICHTENSTEIN, BRIEFMAN & SABELLA PLLC | Agent | 2501 S TAMIAMI TRAIL, SARASOTA, FL 34239 |
| Name | Role | Address |
|---|---|---|
| Lim, Renelle, MD | Member | PO BOX 15853, Sarasota, FL 34277 |
| Name | Role | Address |
|---|---|---|
| LIM, ILYA | Authorized Member | 1617 S TUTTLE AVE, STE 3, SARASOTA, FL 34239 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000049323 | IDO | ACTIVE | 2022-04-18 | 2027-12-31 | No data | 8 PUNKIN PATCH ROAD, WOODBRIDGE, CT, 06525 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-07-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-12-27 | 1617 S. Tuttle Ave,, ste 3, Sarasota, FL 34239 | No data |
| CHANGE OF MAILING ADDRESS | 2022-12-27 | 1617 S. Tuttle Ave,, ste 3, Sarasota, FL 34239 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-03 |
| LC Amendment | 2024-07-10 |
| AMENDED ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-05-02 |
| Florida Limited Liability | 2022-02-22 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
