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CREEKSIDE DERMATOLOGY, PA - Florida Company Profile

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Company Details

Entity Name: CREEKSIDE DERMATOLOGY, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 20 Jul 2017 (8 years ago)
Date of dissolution: 01 Apr 2018 (7 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 01 Apr 2018 (7 years ago)
Document Number: P17000061754
Address: 8630A E COUNTY ROAD 466, THE VILLAGES, FL, 32162, US
Mail Address: 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162, US
ZIP code: 32162
City: The Villages
County: Sumter
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CASPER DAVID President 8620 E COUNTY ROAD 466, THE VILLAGES, FL, 32162
CASPER DAVID Agent 8620 EAST COUNTY ROAD 466, THE VILLAGES, FL, 32162

National Provider Identifier

NPI Number:
1740703818

Authorized Person:

Name:
DR. DAVID CASPER
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Fax:
3523997294

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2018-04-01 - -

Documents

Name Date
Domestic Profit 2017-07-20

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Date of last update: 02 Aug 2025

Sources: Florida Department of State