| Entity Name: | DERMATOLOGY GROUP OF FLORIDA, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Jul 1999 (26 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 27 Aug 2019 (5 years ago) |
| Document Number: | P99000059966 |
| FEI/EIN Number | 65-0932856 |
| Address: | 4000 Hollywood Blvd, Ste 215-S, Hollywood, FL, 33021, US |
| Mail Address: | 4000 Hollywood Blvd, Ste 215-S, Hollywood, FL, 33021, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033854104 | 2022-05-03 | 2022-05-03 | 4000 HOLLYWOOD BLVD STE 215S, HOLLYWOOD, FL, 330211227, US | 154 S COMPASS WAY, DANIA, FL, 330042368, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 954-807-9433 |
Authorized person
| Name | NANCY SEGUIN |
| Role | VP RCM |
| Phone | 9544330455 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Schillinger Jeffery | Chief Executive Officer | 4000 Hollywood Blvd, Hollywood, FL, 33021 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000149097 | RENDON CENTER FOR DERMATOLOGY & AESTHETIC MEDICINE | ACTIVE | 2024-12-09 | 2029-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33025 |
| G23000069741 | JACKSONVILLE BEACH DERMATOLOGY | ACTIVE | 2023-06-07 | 2028-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021 |
| G23000069732 | JAX BEACH DERMATOLOGY | ACTIVE | 2023-06-07 | 2028-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33025 |
| G23000045543 | PLANTATION DERMATOLOGY | ACTIVE | 2023-04-10 | 2028-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FLORIDA, FL, 33021 |
| G23000040292 | HOLLYWOOD DERMATOLOGY | ACTIVE | 2023-03-28 | 2028-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021 |
| G21000080014 | DANIA DERMATOLOGY | ACTIVE | 2021-06-15 | 2026-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FLORIDA, FL, 33021 |
| G17000114421 | THE DERMATOLOGY GROUP OF FLORIDA | EXPIRED | 2017-10-17 | 2022-12-31 | No data | 8220 SW 52 AVE, MIAMI, FL, 33143 |
| G99194900244 | SKIN CENTER OF SOUTH MIAMI | ACTIVE | 1999-07-14 | 2030-12-31 | No data | 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-26 | 4000 Hollywood Blvd, Ste 215-S, Hollywood, FL 33021 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-26 | 4000 Hollywood Blvd, Ste 215-S, Hollywood, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-24 | 1200 South Pine Island Road, Plantation, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-24 | C T Corporation System | No data |
| AMENDMENT | 2019-08-27 | No data | No data |
| AMENDMENT | 2019-08-20 | No data | No data |
| NAME CHANGE AMENDMENT | 2019-08-12 | DERMATOLOGY GROUP OF FLORIDA, P.A. | No data |
| NAME CHANGE AMENDMENT | 2019-08-05 | DERM GROUP OF FL, P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-26 |
| ANNUAL REPORT | 2023-04-24 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-03-05 |
| ANNUAL REPORT | 2020-02-18 |
| Amendment | 2019-08-27 |
| Amendment | 2019-08-20 |
| Name Change | 2019-08-12 |
| Name Change | 2019-08-05 |
| ANNUAL REPORT | 2019-04-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
