| Entity Name: | ELISE CHANG HILLMANN, MD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 07 Nov 1995 (29 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 18 Aug 1997 (27 years ago) |
| Document Number: | P95000085256 |
| FEI/EIN Number | 650617311 |
| Address: | 18990 SE County Line RD, TEQUESTA, FL, 33469, US |
| Mail Address: | 18990 SE County Line RD, TEQUESTA, FL, 33469, US |
| ZIP code: | 33469 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154616811 | 2011-06-10 | 2011-10-25 | 654 W INDIANTOWN RD, #103, JUPITER, FL, 334587546, US | 654 W INDIANTOWN RD, #103, JUPITER, FL, 334587546, US | |||||||||||||||||||||||||
|
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| Phone | +1 561-745-8602 |
| Fax | 5617458673 |
Authorized person
| Name | NICOLE HENDRICKSON |
| Role | PRACTICE MANAGER |
| Phone | 5617458602 |
Taxonomy
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| License Number | ME64945 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1154616811 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HILLMANN ELISE CDr. | Agent | 654 W INDIANTOWN RD, JUPITER, FL, 33458 |
| Name | Role | Address |
|---|---|---|
| HILLMANN ELISE C | Director | 654 W INDIANTOWN RD, SUITE 103, JUPITER, FL, 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-20 | 18990 SE COUNTY LINE RD, TEQUESTA, FL 33469 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-09-23 | 18990 SE County Line RD, TEQUESTA, FL 33469 | No data |
| CHANGE OF MAILING ADDRESS | 2024-09-23 | 18990 SE County Line RD, TEQUESTA, FL 33469 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-02-23 | HILLMANN, ELISE C, Dr. | No data |
| NAME CHANGE AMENDMENT | 1997-08-18 | ELISE CHANG HILLMANN, MD, PA | No data |
| AMENDMENT AND NAME CHANGE | 1997-07-09 | ADVANCED CONCEPTS IN DERMATOLOGY, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-20 |
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-01-30 |
| ANNUAL REPORT | 2018-02-28 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-03-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
