| Entity Name: | ADULT AND PEDIATRIC DERMATOLOGY PRACTITIONERS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Jun 1999 (26 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | P99000058779 |
| FEI/EIN Number | 650934257 |
| Address: | 715 West Boynton Beach Blvd., Boynton Beach, FL, 33426, US |
| Mail Address: | Attn: Jeffrey T. Masessa, c/o 41 Green Pond Road, Rockaway, NJ, 07866, US |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568135507 | 2021-07-27 | 2021-07-27 | 35 GREEN POND RD STE C, ROCKAWAY, NJ, 078662057, US | 13005 SOUTHERN BLVD STE 224, LOXAHATCHEE, FL, 334709272, US | |||||||||||||||||||||||
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| Phone | +1 973-625-0600 |
| Phone | +1 561-793-2929 |
| Fax | 5617907568 |
Authorized person
| Name | JEFFREY T. MASESSA |
| Role | PRESIDENT |
| Phone | 9736250600 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | MA851 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Masessa JEFFREY T | Agent | 715 West Boynton Beach Blvd., Boynton Beach, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| MASESSA JEFFREY | President | c/o 41 Green Pond Road, Rockaway, NJ, 07866 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REINSTATEMENT | 2023-01-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-21 | 715 West Boynton Beach Blvd., Suite C, Boynton Beach, FL 33426 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-05-21 | Masessa, JEFFREY T. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-27 | 715 West Boynton Beach Blvd., Suite C, Boynton Beach, FL 33426 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-27 | 715 West Boynton Beach Blvd., Suite C, Boynton Beach, FL 33426 | No data |
| AMENDMENT | 2011-07-08 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000016574 | ACTIVE | 2023CA1219 | NINETEENTH JUDICIAL CIRCUIT | 2023-11-28 | 2029-01-09 | $369,535.75 | TERRI SPOTTSWOOD 6102 FEDERAL LLC, C/O PO BOX 2401, STUART, FL 34995 |
| J22000108862 | ACTIVE | CACE-21-019845 | BROWARD CIRCUIT COURT | 2022-02-09 | 2027-03-04 | $47,200.11 | LUGAR LLC, C/O 110 TOWER, SUITE 1700, FORT LAUDERDALE, FLORIDA 33301 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2023-01-30 |
| ANNUAL REPORT | 2021-04-01 |
| ANNUAL REPORT | 2020-05-21 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-27 |
| ANNUAL REPORT | 2017-05-03 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-03-20 |
| ANNUAL REPORT | 2014-03-27 |
| ANNUAL REPORT | 2013-01-29 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
