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  5. ADVANCED DERMATOLOGY MANAGEMENT, INC.

ADVANCED DERMATOLOGY MANAGEMENT, INC.

Company Details

Entity Name: ADVANCED DERMATOLOGY MANAGEMENT, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 07 Mar 1997 (28 years ago)
Document Number: P97000021365
FEI/EIN Number 650734508
Address: 1111 PARK CENTRE BLVD, STE #300, MIAMI GARDENS, FL, 33169, US
Mail Address: 1111 PARK CENTRE BLVD, STE #300, MIAMI GARDENS, FL, 33169, US
ZIP code: 33169
County: Miami-Dade
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED DERMATOLOGY MANAGEMENT, INC. WELFARE PLAN 2016 650734508 2017-09-29 ADVANCED DERMATOLOGY MANAGEMENT, INC 289
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-12-01
Business code 621111
Sponsor’s telephone number 3056235595
Plan sponsor’s mailing address 1111 PARK CENTRE BLVD STE 300, MIAMI GARDENS, FL, 331695370
Plan sponsor’s address 1111 PARK CENTRE BLVD STE 300, MIAMI GARDENS, FL, 33169

Number of participants as of the end of the plan year
Active participants 289

Signature of
Role Plan administrator
Date 2017-09-29
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-29
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
ADVANCED DERMATOLOGY MANAGEMENT, INC. WELFARE PLAN 2015 650734508 2016-10-04 ADVANCED DERMATOLOGY MANAGEMENT, INC. 292
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-12-01
Business code 621111
Sponsor’s telephone number 3056235595
Plan sponsor’s mailing address 1111 PARK CENTRE BLVD STE 300, MIAMI GARDENS, FL, 33169
Plan sponsor’s address 1111 PARK CENTRE BLVD STE 300, MIAMI GARDENS, FL, 33169

Number of participants as of the end of the plan year
Active participants 292

Signature of
Role Plan administrator
Date 2016-10-04
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-04
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
ADVANCED DERMATOLOGY MANAGEMENT, INC. WELFARE PLAN 2014 650734508 2015-09-29 ADVANCED DERMATOLOGY MANAGEMENT, INC 268
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-12-01
Business code 621111
Sponsor’s telephone number 3056235595
Plan sponsor’s mailing address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Plan sponsor’s address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169

Number of participants as of the end of the plan year
Active participants 249

Signature of
Role Plan administrator
Date 2015-09-29
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
ADVANCED DERMATOLOGY MANAGEMENT, INC. WELFARE PLAN 2013 650734508 2014-10-17 ADVANCED DERMATOLOGY MANAGEMENT, INC 302
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-12-01
Business code 621111
Sponsor’s telephone number 3056235595
Plan sponsor’s mailing address 111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Plan sponsor’s address 111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169

Plan administrator’s name and address
Administrator’s EIN 650734508
Plan administrator’s name ADVANCED DERMATOLOGY MANAGEMENT, INC
Plan administrator’s address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Administrator’s telephone number 3056235595

Number of participants as of the end of the plan year
Active participants 268

Signature of
Role Plan administrator
Date 2014-10-16
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-16
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
ADVANCED DERMATOLOGY MANAGEMENT, INC. WELFARE PLAN 2012 650734508 2013-07-30 ADVANCED DERMATOLOGY MANAGEMENT, INC 302
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-12-01
Business code 621111
Sponsor’s telephone number 3056235595
Plan sponsor’s mailing address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Plan sponsor’s address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169

Plan administrator’s name and address
Administrator’s EIN 650734508
Plan administrator’s name ADVANCED DERMATOLOGY MANAGEMENT, INC
Plan administrator’s address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Administrator’s telephone number 3056235595

Number of participants as of the end of the plan year
Active participants 268
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-07-30
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-30
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
ADVANCED DERMATOLOGY MANAGEMENT, INC. WELFARE PLAN 2011 650734508 2012-07-11 ADVANCED DERMATOLOGY MANAGEMENT, INC 286
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2001-12-01
Business code 621111
Sponsor’s telephone number 3056235595
Plan sponsor’s mailing address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Plan sponsor’s address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169

Plan administrator’s name and address
Administrator’s EIN 650734508
Plan administrator’s name ADVANCED DERMATOLOGY MANAGEMENT, INC
Plan administrator’s address 1111 PARK CENTRE BOULEVARD, SUITE 300, MIAMI GARDENS, FL, 33169
Administrator’s telephone number 3056235595

Number of participants as of the end of the plan year
Active participants 302
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-07-11
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-11
Name of individual signing KENNETH CHIARELLO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
WAGENER DAVID Agent 1111 PARK CENTRE BLVD, MIAMI, FL, 33169

Director

Name Role Address
NESTOR MARK S Director 1111 PARK CENTER BLVD, STE 300, MIAMI GARDENS, FL, 33169
WAGENER DAVID Director 1111 PARK CENTER BLVD, STE 300, MIAMI GARDENS, FL, 33169
WILENTZ JOEL Director 1111 PARKCENTER BLVD, SUITE 300, MIAMI GARDENS, FL, 33169
GREENE RICHARD M Director 1111 PARK CENTER BLVD, STE 300, MIAMI GARDENS, FL, 33169

Events

Event Type Filed Date Value Description
CONVERSION 2018-03-28 No data CONVERSION MEMBER. NON-QUALIFIED CORPORATION WAS SPC DERMATOLOGY MANAGEMENT, LLC, A. CONVERSION NUMBER 500000180205
MERGER 2018-03-27 No data CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 0. MERGER NUMBER 100000180121

Related by officers

NESTOR MARK S

REJUVENATION CENTERS, INC. MARK STEVEN NESTOR, M.D., PH.D., P.A. SBSJ MEDICAL EDUCATION, LLC REJUVENATION CENTERS, LLC JOMAR COSMECEUTICALS, INC.

WAGENER DAVID

ANATOMIC PATHOLOGY ASSOCIATES, LLC BRIAN BERMAN, M.D., PH.D., P.A. COSMECEUTICAL LABORATORIES, INC. SBSJ MEDICAL EDUCATION, LLC DERMATOLOGY INITIATIVES, INC. RW MANAGEMENT & CONSULTING OF SOUTHWEST FLORIDA, INC. REJUVENATION CENTERS, LLC

WILENTZ JOEL

AMERICAN PLATINUM PROPERTY AND CASUALTY INSURANCE COMPANY DELTA H. INC.

GREENE RICHARD M

COSMECEUTICAL LABORATORIES, INC. RAMM FOODS, INC. IMS PHYSICIANS CORPORATION

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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