| Entity Name: | CLEAR SKIN DERMATOLOGY, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Mar 2019 (6 years ago) |
| Document Number: | P19000026494 |
| FEI/EIN Number | 834184114 |
| Address: | 2454 N MCMULLEN BOOTH ROAD, SUITE 424, CLEARWATER, FL, 33759, US |
| Mail Address: | 2454 N MCMULLEN BOOTH ROAD, SUITE 424, CLEARWATER, FL, 33759, US |
| ZIP code: | 33759 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336792811 | 2019-07-23 | 2019-10-29 | 2454 N MCMULLEN BOOTH RD STE 424, CLEARWATER, FL, 337591339, US | 2454 N MCMULLEN BOOTH RD STE 424, CLEARWATER, FL, 337591339, US | |||||||||||||||||||||||
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| Phone | +1 727-248-0118 |
| Fax | 7272869555 |
Authorized person
| Name | RACHEL EPSTEIN |
| Role | PRESIDENT/OWNER |
| Phone | 7272480118 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WEXLER RACHEL E | Agent | 2454 N McMullen Booth Road, Clearwater, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| WEXLER RACHEL E | President | 3301 BAYSHORE BLVD #1906, TAMPA, FL, 33629 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-20 | 2454 N McMullen Booth Road, Suite 424, Clearwater, FL 33759 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-07-17 | 2454 N MCMULLEN BOOTH ROAD, SUITE 424, CLEARWATER, FL 33759 | No data |
| CHANGE OF MAILING ADDRESS | 2019-07-17 | 2454 N MCMULLEN BOOTH ROAD, SUITE 424, CLEARWATER, FL 33759 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-04-09 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-03-20 |
| Domestic Profit | 2019-03-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
