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  5. KELLY & WOLF, M.D., P.A.

KELLY & WOLF, M.D., P.A.

Company Details

Entity Name: KELLY & WOLF, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 06 Dec 1999 (25 years ago)
Date of dissolution: 21 Sep 2023 (a year ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 21 Sep 2023 (a year ago)
Document Number: P99000105191
FEI/EIN Number 650965636
Mail Address: 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021, US
Address: 9408 SW 87th Avenue, SUITE 301, MIAMI, FL, 33176, US
ZIP code: 33176
County: Miami-Dade
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KELLY & WOLF, M.D., P.A. 401(K) PLAN 2019 650965636 2020-10-15 KELLY & WOLF, M.D., P.A. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. 401(K) PLAN 2018 650965636 2019-10-15 KELLY & WOLF, M.D., P.A. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2018 650965636 2019-04-03 KELLY & WOLF, M.D., P.A. 12
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 SW 88TH STREET, SUITE 903 E, MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2019-04-03
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2017 650965636 2018-03-19 KELLY & WOLF, M.D., P.A. 14
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 SW 88TH STREET, SUITE 903 E, MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2018-03-19
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. 401(K) PLAN 2017 650965636 2018-10-15 KELLY & WOLF, M.D., P.A. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2016 650965636 2017-12-08 KELLY & WOLF, M.D., P.A. 15
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 SW 88TH STREET, SUITE 903 E, MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2017-12-08
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. 401(K) PLAN 2016 650965636 2017-12-12 KELLY & WOLF, M.D., P.A. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2017-12-12
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. 401(K) PLAN 2015 650965636 2016-10-14 KELLY & WOLF, M.D., P.A. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 S.W. 88 STREET, SUITE 903 E., MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature
KELLY & WOLF, M.D., P.A. DEFINED BENEFIT PENSION PLAN 2015 650965636 2016-10-14 KELLY & WOLF, M.D., P.A. 16
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 3055952969
Plan sponsor’s address 8940 SW 88TH STREET, SUITE 903 E, MIAMI, FL, 33176

Plan administrator’s name and address
Administrator’s EIN 650965636
Plan administrator’s name KELLY & WOLF, M.D., P.A.
Plan administrator’s address 8940 SW 88TH STREET, SUITE 903 E, MIAMI, FL, 33176
Administrator’s telephone number 3055952969

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing MICHAEL KELLY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
DERMCARE MANAGEMENT, LLC. Agent

Director

Name Role Address
WOLF CARLOS L Director 8940 N. KENDALL DRIVE SUITE 903-E, MIAMI, FL, 33176

Chief Executive Officer

Name Role Address
Schillinger Jeffrey Chief Executive Officer 4000 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000001786 MPS MEDSPA ACTIVE 2021-01-05 2026-12-31 No data 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021
G16000097453 MIAMI PLASTIC SURGERY ACTIVE 2016-09-07 2027-12-31 No data 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021
G14000132401 MPS MEDSPA EXPIRED 2014-12-31 2019-12-31 No data 8940 NORTH KENDALL DRIVE, SUITE 903-E, MIAMI, FL, 33176

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2023-09-21 No data No data
CHANGE OF PRINCIPAL ADDRESS 2022-08-25 9408 SW 87th Avenue, SUITE 301, MIAMI, FL 33176 No data
REGISTERED AGENT ADDRESS CHANGED 2022-04-27 4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL 33021 No data
CHANGE OF MAILING ADDRESS 2020-02-18 9408 SW 87th Avenue, SUITE 301, MIAMI, FL 33176 No data
REGISTERED AGENT NAME CHANGED 2019-04-03 Dermcare Management No data
NAME CHANGE AMENDMENT 2013-11-20 KELLY & WOLF, M.D., P.A. No data

Documents

Name Date
Voluntary Dissolution 2023-09-21
ANNUAL REPORT 2023-04-11
AMENDED ANNUAL REPORT 2022-11-16
AMENDED ANNUAL REPORT 2022-08-25
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-03-05
ANNUAL REPORT 2020-02-18
AMENDED ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2019-02-21
ANNUAL REPORT 2018-03-30

Related by officers

Schillinger Jeffrey

ANDREW R ALTMAN MD, PA SCHILLINGER DERMCARE INVESTMENTS, INIC. GREATER MIAMI SKIN AND LASER MANAGEMENT INC. FLORIDA ACADEMIC DERMATOLOGY CENTERS, LLC H. ROSS HARRIS, M.D., P.A. HOLLYWOOD DERMATOLOGY AND COSMETIC SURGERY SPECIALISTS, PLLC

Related by address

4000 HOLLYWOOD BLVD, SUITE 215-S, HOLLYWOOD, FL, 33021, US

FLORIDA ACADEMIC DERMATOLOGY CENTERS, LLC H. ROSS HARRIS, M.D., P.A.

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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