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SOUTHEASTERN DERMATOLOGY, P.A.

SOUTHEASTERN DERMATOLOGY, P.A.

Company Details

Entity Name:	SOUTHEASTERN DERMATOLOGY, P.A.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Active
Date Filed:	08 Aug 2001 (23 years ago)
Last Event:	RESTATED ARTICLES AND NAME CHANGE
Event Date Filed:	02 Jun 2016 (9 years ago)
Document Number:	P01000077971
FEI/EIN Number	59-3737893
Address:	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL, 32308, US
Mail Address:	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL, 32308, US
ZIP code:	32308
County:	Leon
Place of Formation:	FLORIDA

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

SOUTHEASTERN DERMATOLOGY, P.A. 401 K PROFIT SHARING PLAN TRUST

2019

593737893

2020-09-24

SOUTHEASTERN DERMATOLOGY P.A.

16

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	621111
Sponsor’s telephone number	8504223376
Plan sponsor’s address	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599

SOUTHEASTERN DERMATOLOGY, P.A. 401 K PROFIT SHARING PLAN TRUST

2018

593737893

2019-10-10

SOUTHEASTERN DERMATOLOGY P.A.

23

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	621111
Sponsor’s telephone number	8504223376
Plan sponsor’s address	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599

SOUTHEASTERN DERMATOLOGY, P.A. 401 K PROFIT SHARING PLAN TRUST

2017

593737893

2018-10-17

SOUTHEASTERN DERMATOLOGY P.A.

21

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	621111
Sponsor’s telephone number	8504223376
Plan sponsor’s address	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599

SOUTHEASTERN DERMATOLOGY, P.A. 401 K PROFIT SHARING PLAN TRUST

2017

593737893

2018-10-12

SOUTHEASTERN DERMATOLOGY P.A.

21

Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	621111
Sponsor’s telephone number	8504223376
Plan sponsor’s address	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599

SOUTHEASTERN DERMATOLOGY, P.A. 401 K PROFIT SHARING PLAN TRUST

2017

593737893

2018-10-15

SOUTHEASTERN DERMATOLOGY P.A.

21

Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	621111
Sponsor’s telephone number	8504223376
Plan sponsor’s address	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599

SOUTHEASTERN DERMATOLOGY, P.A. 401 K PROFIT SHARING PLAN TRUST

2015

593737893

2016-06-24

SOUTHEASTERN DERMATOLOGY P.A.

24

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2001-01-01
Business code	621111
Sponsor’s telephone number	8504223376
Plan sponsor’s address	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 323084599

Signature of

Role	Plan administrator
Date	2016-06-24
Name of individual signing	KAREN CORBIN
Valid signature	Filed with authorized/valid electronic signature

Agent

Name	Role	Address
FORD MICHAEL JM.D.	Agent	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL, 32308

President

Name	Role	Address
FORD MICHAEL J	President	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL, 32308

Director

Name	Role	Address
Ford Marcia E	Director	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL, 32308

Fictitious Names

Registration Number	Fictitious Name	Status	Filed Date	Expiration Date	Cancellation Date	Mailing Address
G08052700091	SOUTHEASTERN DERMATOLOGY	EXPIRED	2008-02-21	2013-12-31	No data	2040 FLEISCHMANN RD, TALLAHASSEE, FL, 32308

Events

Event Type	Filed Date	Value	Description
RESTATED ARTICLES AND NAME CHANGE	2016-06-02	SOUTHEASTERN DERMATOLOGY, P.A.	No data
AMENDMENT AND NAME CHANGE	2007-10-25	SOUTHEASTERN DERMATOLOGY, INC.	No data
REGISTERED AGENT ADDRESS CHANGED	2007-10-25	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL 32308	No data
CHANGE OF PRINCIPAL ADDRESS	2005-04-28	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL 32308	No data
CHANGE OF MAILING ADDRESS	2005-04-28	2040 FLEISCHMANN ROAD, TALLAHASSEE, FL 32308	No data

Documents

Name	Date
ANNUAL REPORT	2025-01-15
AMENDED ANNUAL REPORT	2024-04-02
ANNUAL REPORT	2024-01-03
ANNUAL REPORT	2023-01-26
ANNUAL REPORT	2022-01-26
ANNUAL REPORT	2021-01-09
ANNUAL REPORT	2020-01-08
ANNUAL REPORT	2019-02-07
ANNUAL REPORT	2018-01-12
ANNUAL REPORT	2017-04-11
Restated Articles & Name Chan	2016-06-02
ANNUAL REPORT	2016-05-04
ANNUAL REPORT	2015-04-22
ANNUAL REPORT	2014-05-19
ANNUAL REPORT	2013-04-26
ANNUAL REPORT	2012-01-18
ANNUAL REPORT	2011-01-05
ANNUAL REPORT	2010-01-14
ANNUAL REPORT	2009-02-16
ANNUAL REPORT	2008-04-21

Date of last update: 01 Feb 2025

Sources: Florida Department of State