| Entity Name: | FLORIDA PSYCHOLOGICAL SPECIALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 May 2007 (18 years ago) |
| Document Number: | L07000056817 |
| FEI/EIN Number | 142000565 |
| Address: | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL, 32937, US |
| Mail Address: | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL, 32937, US |
| ZIP code: | 32937 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639379928 | 2007-07-24 | 2008-07-07 | 1127 S PATRICK DR, SUITE 1, SATELLITE BEACH, FL, 329373939, US | 1127 S PATRICK DR, SUITE 1, SATELLITE BEACH, FL, 329373939, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 321-777-4440 |
| Fax | 3217774440 |
Authorized person
| Name | DR. DEMARA BETH BENNETT |
| Role | LICENSED PSYCHOLOGIST |
| Phone | 3217774440 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| License Number | PY 7342 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY 7342 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| License Number | PY 7342 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BENNETT DEMARA B | Agent | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL, 32937 |
| Name | Role | Address |
|---|---|---|
| BENNETT DEMARA B | Manager | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL, 32937 |
| Name | Role | Address |
|---|---|---|
| BENNETT MATTHEW B | Managing Member | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL, 32937 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-30 | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL 32937 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-30 | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL 32937 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-30 | 1071 S Patrick Dr #372042, SATELLITE BEACH, FL 32937 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-22 |
| ANNUAL REPORT | 2023-03-27 |
| ANNUAL REPORT | 2022-02-06 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-04-20 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
