| Entity Name: | LUMINARY DERMATOLOGY OF MIAMI, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Feb 2024 (a year ago) |
| Document Number: | L24000085038 |
| Address: | 925 NE 30TH TERRACE, SUITE 308, HOMESTEAD, FL, 33033 |
| Mail Address: | 4411 BEE RIDGE ROAD, PMB 309, SARASOTA, FL, 34233 |
| ZIP code: | 33033 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114769767 | 2024-06-12 | 2024-06-12 | 4411 BEE RIDGE RD # 309, SARASOTA, FL, 342332514, US | 8740 N KENDALL DR STE 101, MIAMI, FL, 331762209, US | |||||||||||||||||
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| Phone | +1 941-926-6553 |
| Fax | 9412968501 |
| Phone | +1 305-661-8978 |
Authorized person
| Name | JESSICA PHILLIPS |
| Role | CEO |
| Phone | 9419266553 |
Taxonomy
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PHILLIPS JESSICA L | Agent | 4411 BEE RIDGE ROAD, PMB 309, SARASOTA, FL, 34233 |
| Name | Role | Address |
|---|---|---|
| DUNN CARY LM.D. | Manager | 4411 BEE RIDGE ROAD, PMB 309, SARASOTA, FL, 34233 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
