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  5. THE CENTER FOR SKIN CANCER SURGERY, INC.

THE CENTER FOR SKIN CANCER SURGERY, INC.

Company Details

Entity Name: THE CENTER FOR SKIN CANCER SURGERY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 16 May 2014 (11 years ago)
Document Number: P14000044045
FEI/EIN Number 46-5702177
Address: 7960 N Wickham Rd, SUITE 105, MELBOURNE, FL, 32940, US
Mail Address: 7960 N Wickham Rd, Suite 105, Melbourne, FL, 32940, US
ZIP code: 32940
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1871900233 2014-07-17 2023-08-25 8057 SPYGLASS HILL RD, SUITE 102, MELBOURNE, FL, 329408565, US 7960 N WICKHAM RD, SUITE 105, MELBOURNE, FL, 32940, US

Contacts
Phone +1 321-428-4545
Fax 3214217898

Authorized person
Name DR. JEANNINE STEIN
Role OWNER
Phone 3214284545

Taxonomy
Taxonomy Code 207ND0101X - MOHS-Micrographic Surgery Physician
License Number ME88079
State FL
Is Primary Yes

Other Provider Identifiers
Issuer HFMG MA
Number RH580
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE CENTER FOR SKIN CANCER SURGERY, INC. CASH BALANCE PLAN 2023 465702177 2024-09-16 THE CENTER FOR SKIN CANCER SURGERY, INC. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3214284545
Plan sponsor’s address 7960 N. WICKHAM RD, SUITE #105, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2024-09-16
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. 401(K) PLAN 2023 465702177 2024-09-16 THE CENTER FOR SKIN CANCER SURGERY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621493
Sponsor’s telephone number 3214284545
Plan sponsor’s address 7960 N. WICKHAM RD, SUITE 105, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2024-09-16
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. CASH BALANCE PLAN 2022 465702177 2023-10-13 THE CENTER FOR SKIN CANCER SURGERY, INC. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3214284545
Plan sponsor’s address 7960 N. WICKHAM RD, SUITE #105, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. 401(K) PROFIT SHARING PLAN 2022 465702177 2023-09-28 THE CENTER FOR SKIN CANCER SURGERY, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621493
Sponsor’s telephone number 3214284545
Plan sponsor’s address 8057 SPYGLASS HILL ROAD, SUITE 102, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2023-09-28
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. CASH BALANCE PLAN 2021 465702177 2022-09-15 THE CENTER FOR SKIN CANCER SURGERY, INC. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3214284545
Plan sponsor’s address 7960 N. WICKHAM RD, SUITE #105, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2022-09-15
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. 401(K) PROFIT SHARING PLAN 2021 465702177 2022-10-11 THE CENTER FOR SKIN CANCER SURGERY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621493
Sponsor’s telephone number 3214284545
Plan sponsor’s address 8057 SPYGLASS HILL ROAD, SUITE 102, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. 401(K) PROFIT SHARING PLAN 2020 465702177 2021-09-14 THE CENTER FOR SKIN CANCER SURGERY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621493
Sponsor’s telephone number 3214284545
Plan sponsor’s address 8057 SPYGLASS HILL ROAD, SUITE 102, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2021-09-14
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. CASH BALANCE PLAN 2020 465702177 2021-06-02 THE CENTER FOR SKIN CANCER SURGERY, INC. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3214284545
Plan sponsor’s address 7960 N. WICKHAM RD, SUITE #105, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2021-06-02
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. 401(K) PROFIT SHARING PLAN 2019 465702177 2020-06-10 THE CENTER FOR SKIN CANCER SURGERY, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621493
Sponsor’s telephone number 3214284545
Plan sponsor’s address 8057 SPYGLASS HILL ROAD, SUITE 102, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2020-06-10
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature
THE CENTER FOR SKIN CANCER SURGERY, INC. CASH BALANCE PLAN 2019 465702177 2020-05-06 THE CENTER FOR SKIN CANCER SURGERY, INC. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 3214284545
Plan sponsor’s address 8057 SPYGLASS HILL ROAD, SUITE 102, MELBOURNE, FL, 32940

Signature of
Role Plan administrator
Date 2020-05-06
Name of individual signing JEANNINE STEIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
STEIN JEANNINE M Agent 7960 N Wickham Rd, MELBOURNE, FL, 32940

President

Name Role Address
STEIN JEANNINE M President 7960 North Wickham Road, Melbourne, FL, 32940

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2021-09-29 7960 N Wickham Rd, SUITE 105, MELBOURNE, FL 32940 No data
CHANGE OF MAILING ADDRESS 2020-03-04 7960 N Wickham Rd, SUITE 105, MELBOURNE, FL 32940 No data
REGISTERED AGENT ADDRESS CHANGED 2020-03-04 7960 N Wickham Rd, Suite 105, MELBOURNE, FL 32940 No data
REGISTERED AGENT NAME CHANGED 2018-03-01 STEIN, JEANNINE M No data

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-04-11
ANNUAL REPORT 2022-01-31
ANNUAL REPORT 2021-02-02
ANNUAL REPORT 2020-03-04
ANNUAL REPORT 2019-02-06
Reg. Agent Change 2018-03-01
ANNUAL REPORT 2018-01-18
ANNUAL REPORT 2017-01-31
ANNUAL REPORT 2016-03-08

Related by officers

STEIN JEANNINE M

WORLD SKIN CANCER FOUNDATION, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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