| Name: | Advanced Dermatology of Alabama, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 22 Feb 2016 (9 years ago) (Companies founded in February 2016) |
| Entity Number: | 000-353-889 |
| Register Number: | 000353889 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Jefferson County |
| Principal Address: | 151 SOUTHALL LANE SUITE 300MAITLAN, FL 32751 |
| Registered Office Street Address: | 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
| Authorized Capital: | 1,000 @ $.01/PV |
Activities
DERMATOLOGY AND DERMATOPATHOLOGY SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538773775 | 2020-09-04 | 2020-09-04 | 151 SOUTHHALL LN STE 300, MAITLAND, FL, 327517172, US | 286 MITYLENE PARK DR, MONTGOMERY, AL, 361173548, US | |||||||||||||||||||||||||||
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| Phone | +1 407-875-2080 |
| Fax | 4076503455 |
Authorized person
| Name | MATT LEAVITT |
| Role | OWNER |
| Phone | 4078752080 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207ND0101X - MOHS-Micrographic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 207ND0900X - Dermatopathology Physician |
| Is Primary | No |
| Taxonomy Code | 207NS0135X - Procedural Dermatology Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Name | Role | Address |
|---|---|---|
| HORTON, WILLIAM W | Incorporator | JONES WALKER LLP, 420 20TH STREET NOBIRMINGHAM, AL 35203-5840 |
| Name | Role | Address |
|---|---|---|
| LEAVITT, MATT L | Director | 1343 CLASSIC COURT NORTHLONGWOOD, FL 32779 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
