| Entity Name: | PREMIER DERMATOLOGY ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 11 Aug 2023 (2 years ago) |
| Document Number: | P23000059040 |
| FEI/EIN Number | 93-2879412 |
| Address: | 1920 E. HALLANDALE BEACH BLVD, STE 607 PMB1020, HALLANDALE BEACH, FL 33009 |
| Mail Address: | 214 AMHERST ST, BROOKLYN, NY 11235 |
| ZIP code: | 33009 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730956855 | 2023-12-08 | 2023-12-08 | 214 AMHERST ST, BROOKLYN, NY, 112354117, US | 825 CORAL RIDGE DR, CARDIOVASCULAR SUITES, CORAL SPRINGS, FL, 330714180, US | |||||||||||||||||||||||||
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| Phone | +1 917-804-4553 |
| Fax | 9179756272 |
| Phone | +1 305-810-8846 |
Authorized person
| Name | MR. ARKADY KALYUZHNY |
| Role | PRESIDENT |
| Phone | 9178044553 |
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 |
|---|---|---|
| Vergilis-Kalner, Irene | Agent | 1920 E. HALLANDALE BEACH BLVD, STE 607 PMB1020, HALLANDALE BEACH, FL 33009 |
| Name | Role | Address |
|---|---|---|
| Vergilis-Kalner, Irene | President | 214 AMHERST ST, BROOKLYN, NY 11235 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-04 | Vergilis-Kalner, Irene | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-04 |
| Domestic Profit | 2023-08-11 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
