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SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A. - Florida Company Profile

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Company Details

Entity Name: SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 02 Nov 2011 (14 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 20 Oct 2016 (9 years ago)
Document Number: P11000095389
FEI/EIN Number 453732466
Address: 865 SAXON BLVD, Orange City, FL, 32763, US
Mail Address: 426 S Riverside Drive, New Symrna Beach, FL, 32168, US
ZIP code: 32763
City: Orange City
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Wheeler Ross C Manager 865 Saxon Blvd, Orange City, FL, 32763
Spradley Ellen G Agent 111 A Executive Circle, Daytona Beach, FL, 32114

National Provider Identifier

NPI Number:
1427841865
Certification Date:
2025-05-28

Authorized Person:

Name:
SHAWNA FRAME
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
3869607863

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G18000078341 SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A. EXPIRED 2018-07-19 2023-12-31 - 865 SAXON BLVD, ORANGE CITY, FL, 32763
G12000101165 SKIN DERMATOLOGY AND MED SPA EXPIRED 2012-10-16 2017-12-31 - 5519 AVENUE DU SOLEIL, LUTZ, FL, 33558

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2024-01-31 111 A Executive Circle, Daytona Beach, FL 32114 -
REGISTERED AGENT NAME CHANGED 2024-01-31 Spradley, Ellen G -
CHANGE OF MAILING ADDRESS 2023-02-22 865 SAXON BLVD, Orange City, FL 32763 -
CHANGE OF PRINCIPAL ADDRESS 2018-05-14 865 SAXON BLVD, Orange City, FL 32763 -
REINSTATEMENT 2016-10-20 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 - -
AMENDMENT 2015-06-04 - -

Documents

Name Date
ANNUAL REPORT 2025-01-27
ANNUAL REPORT 2024-01-31
ANNUAL REPORT 2023-02-22
ANNUAL REPORT 2022-02-26
ANNUAL REPORT 2021-04-29
ANNUAL REPORT 2020-01-20
ANNUAL REPORT 2019-05-16
AMENDED ANNUAL REPORT 2018-06-19
ANNUAL REPORT 2018-02-15
ANNUAL REPORT 2017-04-19

USAspending Awards / Financial Assistance

Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
42000.00
Total Face Value Of Loan:
42000.00
Date:
2020-04-29
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
42000.00
Total Face Value Of Loan:
42000.00

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Date of last update: 03 Aug 2025

Sources: Florida Department of State