| Entity Name: | C. VINCENT DIX, PHD., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 28 Dec 2004 (20 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | L04000093668 |
| FEI/EIN Number | 201849105 |
| Address: | 2880 CAPITAL MEDICAL BOULEVARD, SUITE 2, TALLAHASSEE, FL, 32308 |
| Mail Address: | 2880 CAPITAL MEDICAL BOULEVARD, SUITE 2, TALLAHASSEE, FL, 32308 |
| ZIP code: | 32308 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366632812 | 2007-07-31 | 2007-11-14 | 2880 CAPITAL MEDICAL BLVD, SUITE 2, TALLAHASSEE, FL, 323084671, US | 2880 CAPITAL MEDICAL BLVD, SUITE 2, TALLAHASSEE, FL, 323084671, US | |||||||||||||||||||||||||
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| Fax | 8502221194 |
| Phone | +1 850-878-1142 |
Authorized person
| Name | C VINCENT DIX |
| Role | PROVIDER |
| Phone | 8508781142 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY002151 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 75943 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HUNTER CURTIS B | Agent | 3450 PACES FERRY ROAD, TALLAHASSEE, FL, 32309 |
| Name | Role | Address |
|---|---|---|
| C. VINCENT DIX, PH.D., LLC | Manager | 2880 CAPITAL MEDICAL BLVD. SUITE 2, TALLAHASSEE, FL, 32308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-01-13 | 2880 CAPITAL MEDICAL BOULEVARD, SUITE 2, TALLAHASSEE, FL 32308 | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-13 | 2880 CAPITAL MEDICAL BOULEVARD, SUITE 2, TALLAHASSEE, FL 32308 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-01-31 |
| ANNUAL REPORT | 2007-01-09 |
| ANNUAL REPORT | 2006-01-13 |
| ANNUAL REPORT | 2005-02-08 |
| Florida Limited Liabilites | 2004-12-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
