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  5. PALM HARBOR DERMATOLOGY, P.A.

PALM HARBOR DERMATOLOGY, P.A.

Company Details

Entity Name: PALM HARBOR DERMATOLOGY, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 20 Mar 2008 (17 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 02 Nov 2023 (a year ago)
Document Number: P08000029426
FEI/EIN Number 262291600
Mail Address: 4919 Memorial Highway, Suite 150, Tampa, FL, 33634, US
Address: 4197 WOODLANDS PARKWAY, 2ND FLOOR, PALM HARBOR, FL, 34685
ZIP code: 34685
County: Pinellas
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PALM HARBOR DERMATOLOGY, P.A. 401(K) PLAN 2014 262291600 2015-10-15 PALM HARBOR DERMATOLOGY, P.A. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 7277863810
Plan sponsor’s address 4197 WOODLANDS PARKWAY, 2ND FLOOR, PALM HARBOR, FL, 34685
PALM HARBOR DERMATOLOGY, P.A. 401(K) PLAN 2013 262291600 2014-10-15 PALM HARBOR DERMATOLOGY, P.A. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621399
Sponsor’s telephone number 7277863810
Plan sponsor’s address 4197 WOODLANDS PARKWAY, 2ND FLOOR, PALM HARBOR, FL, 34685

Signature of
Role Plan administrator
Date 2014-10-15
Name of individual signing AMY ROSS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROSS AMY SDr. Agent 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34683

Manager

Name Role Address
ROSS AMY S Manager 4197 WOODLANDS PKWY, 2ND FLOOR, PALM HARBOR, FL, 34685

Director

Name Role Address
ROSS AMY S Director 4197 WOODLANDS PKWY, 2ND FLOOR, PALM HARBOR, FL, 34685

Chief Financial Officer

Name Role Address
Jackson Matthew D Chief Financial Officer 4919 Memorial Highway, Tampa, FL, 33634

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000154697 PHDERMATOLOGY SRQ ACTIVE 2024-12-20 2029-12-31 No data 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34685
G24000142264 PHDERMATOLOGY SOUTH SRQ ACTIVE 2024-11-21 2029-12-31 No data 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34685
G24000139783 PHDERMATOLOGY PALMER RANCH ACTIVE 2024-11-15 2029-12-31 No data 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34685
G24000139777 PHDERMATOLOGY LUTZ ACTIVE 2024-11-15 2029-12-31 No data 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34685
G24000139781 PHDERMATOLOGY SARASOTA ACTIVE 2024-11-15 2029-12-31 No data 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34685
G24000137880 FORCARE DERMATOLOGY ACTIVE 2024-11-12 2029-12-31 No data 4197 WOODLANDS PKWY, PALM HARBOR, FL, 34685
G23000032886 SATYA SARASOTA DERMATOLOGY ACTIVE 2023-03-11 2028-12-31 No data 4919 MEMORIAL HWY, SUITE 150, TAMPA, FL, 33634
G23000026875 SATYA SARASOTA DERMATOLOGY ACTIVE 2023-02-27 2028-12-31 No data 4136 RIDGEMOOR DR N, PALM HARBOR, FL, 34685
G22000142919 DERMATOLOGY OF COASTAL SARASOTA ACTIVE 2022-11-16 2027-12-31 No data 4919 MEMORIAL HWY, SUITE 150, TAMPA, FL, 33634
G22000069162 TRUEBLUE CLINICAL RESEARCH ACTIVE 2022-06-06 2027-12-31 No data 1104 KYLE WOOD LANE, BRANDON, FL, 33511

Events

Event Type Filed Date Value Description
REINSTATEMENT 2023-11-02 No data No data
REGISTERED AGENT NAME CHANGED 2023-11-02 ROSS, AMY S, Dr. No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2023-09-22 No data No data
CHANGE OF MAILING ADDRESS 2022-03-29 4197 WOODLANDS PARKWAY, 2ND FLOOR, PALM HARBOR, FL 34685 No data
REGISTERED AGENT ADDRESS CHANGED 2009-04-27 4197 WOODLANDS PKWY, 2ND FLOOR, PALM HARBOR, FL 34683 No data
CONVERSION 2008-03-20 No data CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS L07000098455. CONVERSION NUMBER 500000086025

Documents

Name Date
ANNUAL REPORT 2024-02-07
REINSTATEMENT 2023-11-02
ANNUAL REPORT 2022-03-29
ANNUAL REPORT 2021-04-09
ANNUAL REPORT 2020-05-20
ANNUAL REPORT 2019-02-11
ANNUAL REPORT 2018-03-26
ANNUAL REPORT 2017-02-05
ANNUAL REPORT 2016-03-25
ANNUAL REPORT 2015-02-24

Related by officers

ROSS AMY S

ROSS REAL ESTATE, LLC 1022 MAIN STREET R LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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