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Sunrise Dermatology, LLC

Details

Name: Sunrise Dermatology, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 06 Jan 2011 (14 years ago) (Companies founded in January 2011)
Entity Number: 000-305-947
Register Number: 000305947
ZIP code: 36606 (Companies in Mobile, 36606)
County: Mobile
Place of Formation: Mobile County
Principal Address: MOBILE, AL
Registered Office Street Address: 70 MIDTOWN PARK EMOBILE, AL 36606

Activities PRACTICE OF DERMATOLOGY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1538630751 2018-12-16 2019-02-07 70 MIDTOWN PARK E, MOBILE, AL, 366064140, US 8832 US HWY 90, DAPHNE, AL, 36526, US

Contacts

Phone +1 251-544-6407
Fax 2515446411
Phone +1 251-289-1786

Authorized person

Name SARAH WIERSZALOWSKI
Role ADMINISTRATOR
Phone 2515446407

Taxonomy

Taxonomy Code 207N00000X - Dermatology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2020 274546299 2021-04-19 SUNRISE DERMATOLOGY, LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2021-04-19
Name of individual signing RYAN RAMAGOSA
Role Employer/plan sponsor
Date 2021-04-19
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2019 274546299 2020-03-17 SUNRISE DERMATOLOGY, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2020-03-16
Name of individual signing RYAN RAMAGOSA
Role Employer/plan sponsor
Date 2020-03-16
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2018 274546299 2019-04-08 SUNRISE DERMATOLOGY, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2019-04-08
Name of individual signing RYAN RAMAGOSA
Role Employer/plan sponsor
Date 2019-04-08
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2017 274546299 2018-04-25 SUNRISE DERMATOLOGY, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2018-04-25
Name of individual signing RYAN RAMAGOSA
Role Employer/plan sponsor
Date 2018-04-25
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2016 274546299 2017-05-11 SUNRISE DERMATOLOGY, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2017-05-10
Name of individual signing RYAN RAMAGOSA
Role Employer/plan sponsor
Date 2017-05-10
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2015 274546299 2016-05-27 SUNRISE DERMATOLOGY, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2016-05-26
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2014 274546299 2015-03-16 SUNRISE DERMATOLOGY, LLC 10
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2015-03-16
Name of individual signing RYAN RAMAGOSA
SUNRISE DERMATOLOGY, LLC 401(K) PLAN 2014 274546299 2015-06-18 SUNRISE DERMATOLOGY, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2512891786
Plan sponsor’s address 70 MIDTOWN PARK EAST, MOBILE, AL, 36606

Signature of

Role Plan administrator
Date 2015-06-18
Name of individual signing SCOTT FREEMAN
Role Employer/plan sponsor
Date 2015-06-18
Name of individual signing SCOTT FREEMAN

Agent

Name Role Address
FREEMAN, SCOTT R Agent PO BOX 2385MOBILE, AL 36652

Member

Name Role Address
FREEMAN, SCOTT R Member PO BOX 2385MOBILE, AL 36652
RAMAGOSA, RYAN B Member 9851 E CAROLINA PLDENVER, CO 80247

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State