| Entity Name: | FLORIDA CENTER FOR DERMATOLOGY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Feb 2012 (13 years ago) |
| Document Number: | P12000016468 |
| FEI/EIN Number | 45-4717431 |
| Address: | 1301 Plantation Island Dr S, Suite 106B, ST. AUGUSTINE, FL, 32080, US |
| Mail Address: | PO Box 3044, ST. AUGUSTINE, FL, 32085, US |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073870341 | 2012-04-11 | 2012-04-11 | 105 SOUTHPARK BLVD, SUITE A103, ST AUGUSTINE, FL, 320865191, US | 105 SOUTHPARK BLVD, SUITE A103, ST AUGUSTINE, FL, 320865191, US | |||||||||||||||||||
|
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| Phone | +1 904-342-7765 |
| Fax | 9043427770 |
Authorized person
| Name | DR. JONATHAN KANTOR |
| Role | PRESIDENT |
| Phone | 9043427765 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| License Number | ME92201 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KANTOR JONATHAN | Agent | 1301 Plantation Island Dr S, ST. AUGUSTINE, FL, 32080 |
| Name | Role | Address |
|---|---|---|
| KANTOR JONATHAN | President | 1301 Plantation Island Dr S, ST. AUGUSTINE, FL, 32080 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000134893 | AMERICAN DERMATOLOGY, MOHS, AND COSMETIC SURGERY CENTERS | ACTIVE | 2024-11-04 | 2029-12-31 | No data | PO BOX 3044, ST AUGUSTINE, FL, 32085 |
| G23000154713 | FLORIDA CENTER FOR DERMATOLOGY LABORATORY II | ACTIVE | 2023-12-19 | 2028-12-31 | No data | PO BOX 3044, ST AUGUSTINE, FL, 32085 |
| G12000073559 | FLORIDA CENTER FOR DERMATOLOGY LABORATORY | ACTIVE | 2012-07-24 | 2027-12-31 | No data | PO BOX 3044, ST AUGUSTINE, FL, 32085 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-01-10 | 1301 Plantation Island Dr S, Suite 106B, ST. AUGUSTINE, FL 32080 | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-10 | 1301 Plantation Island Dr S, Suite 106B, ST. AUGUSTINE, FL 32080 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-01-10 | 1301 Plantation Island Dr S, Suite 106B, ST. AUGUSTINE, FL 32080 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-03-15 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-24 |
| ANNUAL REPORT | 2015-01-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
