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SKIN WELLNESS CENTER, P.A. - Florida Company Profile

Company Details

Entity Name: SKIN WELLNESS CENTER, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

SKIN WELLNESS CENTER, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 08 Oct 2004 (21 years ago)
Last Event: AMENDMENT
Event Date Filed: 10 Aug 2006 (19 years ago)
Document Number: P04000139630
FEI/EIN Number 201714408

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782-44, 23
Mail Address: C/O KOEHLER & COMPANY, 401 NORTH HOWARD AVENUE, TAMPA, FL, 33606
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1528176146 2006-08-25 2008-01-10 PO BOX 1548, PINELLAS PARK, FL, 337801548, US 9005 BELCHER RD, PINELLAS PARK, FL, 337824423, US

Contacts
Phone +1 727-545-3376
Fax 7275455003

Authorized person
Name DR. MELANIE R HAYNES
Role PRESIDENT DERMATOLOGIST
Phone 7275453376

Taxonomy
Taxonomy Code 207NS0135X - Procedural Dermatology Physician
License Number ME48813
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number 12272
State FL
Issuer CIGNA VENDOR NUMBER
Number AS20877590001
State FL
Issuer AETNA
Number 1081799
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2023 201714408 2024-07-23 SKIN WELLNESS CENTER, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD N, PINELLAS PARK, FL, 33782
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2022 201714408 2023-07-19 SKIN WELLNESS CENTER, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD N, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2023-07-19
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2021 201714408 2022-10-13 SKIN WELLNESS CENTER, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD N, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2022-10-13
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-13
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2020 201714408 2021-09-10 SKIN WELLNESS CENTER, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2021-09-10
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-10
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2019 201714408 2020-07-22 SKIN WELLNESS CENTER, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2020-07-22
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2018 201714408 2019-09-27 SKIN WELLNESS CENTER, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2019-09-27
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-27
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2017 201714408 2018-06-28 SKIN WELLNESS CENTER, P.A. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2018-06-28
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2016 201714408 2017-08-14 SKIN WELLNESS CENTER, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2017-08-14
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2015 201714408 2016-07-20 SKIN WELLNESS CENTER, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2016-07-20
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
SKIN WELLNESS CENTER, P.A. 401(K) PLAN 2014 201714408 2015-07-20 SKIN WELLNESS CENTER, P.A. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-07-07
Business code 621111
Sponsor’s telephone number 7275453376
Plan sponsor’s address 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782

Signature of
Role Plan administrator
Date 2015-07-20
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-20
Name of individual signing JACK CARTER
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
HAYNES MELANIE R President 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782
HAYNES MELANIE R Secretary 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782
CARTER CLARENCE J Vice President 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782
CARTER CLARENCE J Treasurer 9005 BELCHER ROAD, PINELLAS PARK, FL, 33782
KOEHLER KEITH W Agent 401 NORTH HOWARD AVENUE, TAMPA, FL, 33606

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2008-04-24 9005 BELCHER ROAD, PINELLAS PARK, FL 33782-44 23 -
CHANGE OF MAILING ADDRESS 2007-04-28 9005 BELCHER ROAD, PINELLAS PARK, FL 33782-44 23 -
REGISTERED AGENT ADDRESS CHANGED 2007-04-28 401 NORTH HOWARD AVENUE, TAMPA, FL 33606 -
AMENDMENT 2006-08-10 - -

Documents

Name Date
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-01-25
ANNUAL REPORT 2022-01-21
ANNUAL REPORT 2021-01-29
ANNUAL REPORT 2020-01-21
ANNUAL REPORT 2019-03-13
ANNUAL REPORT 2018-01-30
ANNUAL REPORT 2017-01-05
ANNUAL REPORT 2016-01-22
ANNUAL REPORT 2015-02-24

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5458008409 2021-02-08 0455 PPS 9005 Belcher Rd N, Pinellas Park, FL, 33782-4423
Loan Status Date 2021-10-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 150000
Loan Approval Amount (current) 150000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Pinellas Park, PINELLAS, FL, 33782-4423
Project Congressional District FL-13
Number of Employees 8
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 150747.95
Forgiveness Paid Date 2021-09-01

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Date of last update: 01 May 2025

Sources: Florida Department of State

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