| Entity Name: | MICHAEL FISH PHD, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
MICHAEL FISH PHD, PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 25 Apr 1988 (37 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 18 Oct 1994 (31 years ago) |
| Document Number: | K21782 |
| FEI/EIN Number |
650038904
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 4581 WESTON RD., WESTON, FL, 33331, US |
| Address: | 10200 W STATE RD 84, DAVIE, FL, 33324, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376723478 | 2007-11-06 | 2017-10-09 | 1304 SW 160TH AVE, SUITE 339, SUNRISE, FL, 333261902, US | 10200 W STATE ROAD 84 STE 105, DAVIE, FL, 333244218, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 954-370-7692 |
| Fax | 9543702383 |
Authorized person
| Name | DR. MICHAEL FISH |
| Role | PRESIDENT/PSYCHOLOGIST |
| Phone | 9543707692 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY3726 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 73683 |
| State | FL |
| Issuer | VALUE OPTIONS/TRICARE |
| Number | 056610 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FISH MICHAEL DR. | President | 10200 W STATE RD 84, DAVIE, FL, 33324 |
| FISH MICHAEL D | Agent | 10200 W STATE RD 84, DAVIE, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-02-17 | 10200 W STATE RD 84, STE. 105, DAVIE, FL 33324 | - |
| CHANGE OF MAILING ADDRESS | 2018-02-17 | 10200 W STATE RD 84, STE. 105, DAVIE, FL 33324 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-17 | 10200 W STATE RD 84, STE. 105, DAVIE, FL 33324 | - |
| REGISTERED AGENT NAME CHANGED | 2005-04-22 | FISH, MICHAEL DR. | - |
| REINSTATEMENT | 1994-10-18 | - | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1994-08-26 | - | - |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J19000213312 | TERMINATED | 1000000819297 | BROWARD | 2019-03-12 | 2029-03-20 | $ 7,945.47 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J14000609346 | TERMINATED | 1000000615475 | BROWARD | 2014-05-05 | 2024-05-09 | $ 967.59 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J13000952102 | TERMINATED | 1000000497114 | BROWARD | 2013-05-16 | 2023-05-22 | $ 1,060.82 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-24 |
| ANNUAL REPORT | 2023-01-11 |
| ANNUAL REPORT | 2022-04-03 |
| ANNUAL REPORT | 2021-02-06 |
| ANNUAL REPORT | 2020-02-29 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-02-17 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-04-08 |
| ANNUAL REPORT | 2015-04-15 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
