| Entity Name: | SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
SKIN DERMATOLOGY AND COSMETIC SERVICES, 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: | 02 Nov 2011 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 20 Oct 2016 (9 years ago) |
| Document Number: | P11000095389 |
| FEI/EIN Number |
453732466
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 865 SAXON BLVD, Orange City, FL, 32763, US |
| Mail Address: | 426 S Riverside Drive, New Symrna Beach, FL, 32168, US |
| ZIP code: | 32763 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003582123 | 2021-08-18 | 2021-08-18 | 865 SAXON BLVD, ORANGE CITY, FL, 327638204, US | 84 PINNACLES DR STE 400, PALM COAST, FL, 321642324, US | |||||||||||||||||||||
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| Phone | +1 386-256-1969 |
| Fax | 4075997506 |
Authorized person
| Name | SHAWNA FRAME |
| Role | BILLING MANAGER |
| Phone | 4235255993 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009563608 |
| State | FL |
| 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 |
| 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 |
| 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 | - | - |
| 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 |
Date of last update: 03 Apr 2025
Sources: Florida Department of State
