Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Indian River
    4. ›
  4. 32960
    5. ›
  5. SUNNYCOAST DERMATOLOGY, INC.

SUNNYCOAST DERMATOLOGY, INC.

Company Details

Entity Name: SUNNYCOAST DERMATOLOGY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Mar 2001 (24 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 07 Mar 2012 (13 years ago)
Document Number: P01000028599
FEI/EIN Number 651088005
Address: 3900 20th Street, Vero Beach, FL, 32960, US
Mail Address: 3900 20th Street, Vero Beach, FL, 32960, US
ZIP code: 32960
County: Indian River
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1962487546 2005-12-07 2020-08-22 1850 43RD AVE, SUITE 4 & 5 C, VERO BEACH, FL, 329600504, US 1850 43RD AVE, SUITE 4 & 5 C, VERO BEACH, FL, 329600504, US

Contacts
Phone +1 772-299-4000
Fax 7722994001

Authorized person
Name THEODOR MAJOR RUDOLPH
Role MEDICAL DIRECTOR/MEDICAL DOCTOR
Phone 7722994000

Taxonomy
Taxonomy Code 207N00000X - Dermatology Physician
License Number ME79805
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUNNYCOAST DERMATOLOGY INC 401 K PROFIT SHARING PLAN TRUST 2015 651088005 2016-06-16 SUNNYCOAST DERMATOLOGY INC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVE STE C4, VERO BEACH, FL, 329600501

Signature of
Role Plan administrator
Date 2016-06-16
Name of individual signing THEODOR RUDOLPH
Valid signature Filed with authorized/valid electronic signature
SUNNYCOAST DERMATOLOGY INC 401 K PROFIT SHARING PLAN TRUST 2014 651088005 2015-06-08 SUNNYCOAST DERMATOLOGY 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVE STE C4, VERO BEACH, FL, 329600501

Signature of
Role Plan administrator
Date 2015-06-08
Name of individual signing THEODOR RUDOLPH
Valid signature Filed with authorized/valid electronic signature
SUNNYCOAST DERMATOLOGY INC 401 K PROFIT SHARING PLAN TRUST 2013 651088005 2014-05-05 SUNNYCOAST DERMATOLOGY 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVE STE C4, VERO BEACH, FL, 329600501

Signature of
Role Plan administrator
Date 2014-05-05
Name of individual signing THEODOR RUDOLPH MD
Valid signature Filed with authorized/valid electronic signature
SUNNYCOAST DERMATOLOGY INC 401 K PROFIT SHARING PLAN TRUST 2012 651088005 2013-06-27 SUNNYCOAST DERMATOLOGY 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVE STE C4, VERO BEACH, FL, 329600501

Signature of
Role Plan administrator
Date 2013-06-27
Name of individual signing SUNNYCOAST DERMATOLOGY
Valid signature Filed with authorized/valid electronic signature
SUNNYCOAST DERMATOLOGY INC 401 K PROFIT SHARING PLAN TRUST 2011 651088005 2012-05-23 SUNNYCOAST DERMATOLOGY 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVE STE C4, VERO BEACH, FL, 329600501

Plan administrator’s name and address
Administrator’s EIN 651088005
Plan administrator’s name SUNNYCOAST DERMATOLOGY
Plan administrator’s address 1850 43RD AVE STE C4, VERO BEACH, FL, 329600501
Administrator’s telephone number 7722994000

Signature of
Role Plan administrator
Date 2012-05-23
Name of individual signing SUNNYCOAST DERMATOLOGY
Valid signature Filed with authorized/valid electronic signature
SUNNYCOAST DERMATOLOGY INC 401 K PROFIT SHARING PLAN TRUST 2010 651088005 2011-07-27 SUNNYCOAST DERMATOLOGY 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVENUE, STE 4 5, VERO BEACH, FL, 32960

Plan administrator’s name and address
Administrator’s EIN 651088005
Plan administrator’s name SUNNYCOAST DERMATOLOGY
Plan administrator’s address 1850 43RD AVENUE, STE 4 5, VERO BEACH, FL, 32960
Administrator’s telephone number 7722994000

Signature of
Role Plan administrator
Date 2011-07-27
Name of individual signing SUNNYCOAST DERMATOLOGY
Valid signature Filed with authorized/valid electronic signature
SUNNYCOAST DERMATOLOGY INC 2009 651088005 2010-07-22 SUNNYCOAST DERMATOLOGY 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7722994000
Plan sponsor’s address 1850 43RD AVENUE, STE 4 5, VERO BEACH, FL, 32960

Plan administrator’s name and address
Administrator’s EIN 651088005
Plan administrator’s name SUNNYCOAST DERMATOLOGY
Plan administrator’s address 1850 43RD AVENUE, STE 4 5, VERO BEACH, FL, 32960
Administrator’s telephone number 7722994000

Signature of
Role Plan administrator
Date 2010-07-22
Name of individual signing SUNNYCOAST DERMATOLOGY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RUDOLPH THEODOR M Agent 3900 20th Street, Vero Beach, FL, 32960

Manager

Name Role Address
RUDOLPH THEODOR MDr. Manager 3900 20th Street, Vero Beach, FL, 32960

Director

Name Role Address
RUDOLPH THEODOR MDr. Director 3900 20th Street, Vero Beach, FL, 32960

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2020-03-26 3900 20th Street, Vero Beach, FL 32960 No data
CHANGE OF MAILING ADDRESS 2020-03-26 3900 20th Street, Vero Beach, FL 32960 No data
REGISTERED AGENT ADDRESS CHANGED 2020-03-26 3900 20th Street, Vero Beach, FL 32960 No data
REINSTATEMENT 2012-03-07 No data No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2011-09-23 No data No data
REGISTERED AGENT NAME CHANGED 2002-04-29 RUDOLPH, THEODOR M No data

Documents

Name Date
ANNUAL REPORT 2024-01-19
ANNUAL REPORT 2023-03-30
ANNUAL REPORT 2022-02-02
ANNUAL REPORT 2021-04-19
ANNUAL REPORT 2020-03-26
ANNUAL REPORT 2019-02-21
ANNUAL REPORT 2018-03-19
ANNUAL REPORT 2017-02-09
ANNUAL REPORT 2016-04-18
AMENDED ANNUAL REPORT 2015-01-23

Related by officers

RUDOLPH THEODOR M

SUNNYSIDE DEVELOPMENT, LLC

Related by address

3900 20th Street, Vero Beach, FL, 32960, US

SUNNYSIDE DEVELOPMENT, LLC

3900 20th Street, Vero Beach, FL, 32960, US

SUNNYSIDE DEVELOPMENT, LLC

Date of last update: 03 Feb 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated