| Entity Name: | CAUVIN FRETT PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 22 Dec 2003 (21 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L03000055174 |
| FEI/EIN Number | 20-0504885 |
| Mail Address: | 10254 BROOKVILLE LANE, BOCA RATON, FL 33428 |
| Address: | 23123 State Road 7, 230A, BOCA RATON, FL 33428 |
| ZIP code: | 33428 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144599242 | 2011-12-19 | 2011-12-19 | 10254 BROOKVILLE LN, BOCA RATON, FL, 334285869, US | 8177 GLADES RD STE 204, BOCA RATON, FL, 334344022, US | |||||||||||||||||||||||
|
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| Phone | +1 561-483-9599 |
Authorized person
| Name | DR. CAUVIN FRETT |
| Role | PHYSICIAN |
| Phone | 5614839599 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME0058595 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 259575300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAUVIN, FRETT | Agent | 10254 BROOKVILLE LANE, BOCA RATON, FL 33428 |
| Name | Role | Address |
|---|---|---|
| FRETT, CAUVIN | Manager | 10254 BROOKVILLE LANE, BOCA RATON, FL 33428 |
| Name | Role | Address |
|---|---|---|
| FRETT, BERNADETTE | Managing Member | 10254 BROOKVILLE LANE, BOCA RATON, FL 33428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-05-01 | 23123 State Road 7, 230A, BOCA RATON, FL 33428 | No data |
| CHANGE OF MAILING ADDRESS | 2006-04-29 | 23123 State Road 7, 230A, BOCA RATON, FL 33428 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-29 | CAUVIN, FRETT | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-04-29 | 10254 BROOKVILLE LANE, BOCA RATON, FL 33428 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-14 |
| ANNUAL REPORT | 2011-04-29 |
| ANNUAL REPORT | 2010-04-25 |
| ANNUAL REPORT | 2009-04-28 |
| ANNUAL REPORT | 2008-04-21 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
