| Entity Name: | CENTER FOR HUMAN FORMATION, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 Dec 2009 (15 years ago) |
| Date of dissolution: | 26 Apr 2013 (12 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 26 Apr 2013 (12 years ago) |
| Document Number: | L09000118174 |
| FEI/EIN Number | 364663797 |
| Address: | 9495 SW 72ND STREET, SUITE B-295, MIAMI, FL, 33173, US |
| Mail Address: | 9495 SW 72ND STREET, SUITE B-295, MIAMI, FL, 33173, US |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831428838 | 2009-12-22 | 2011-07-20 | PO BOX 140432, CORAL GABLES, FL, 331140432, US | 301 ALMERIA AVE, SUITE 210, CORAL GABLES, FL, 331345822, US | |||||||||||||||||
|
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| Phone | +1 786-879-7007 |
Authorized person
| Name | DR. CARLOS CAMILO GOMEZ |
| Role | PSYCHOLOGIST |
| Phone | 7868797007 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY 7327 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOMEZ CARLOS C | Agent | 9495 SW 72ND STREET, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| GOMEZ CARLOS C | President | PO BOX 140432, CORAL GABLES, FL, 331140432 |
| Name | Role | Address |
|---|---|---|
| GOMEZ HOLLY | Manager | 9495 SW 72ND ST - STE B295, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| DR CARLOS C GOMEZ AND ASSOCIATES PA | Managing Member | 9495 SW 72ND ST - STE B295, MIAMI, FL, 33173 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-26 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2012-12-26 | CENTER FOR HUMAN FORMATION, PLLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-26 | 9495 SW 72ND STREET, SUITE B-295, MIAMI, FL 33173 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-26 | 9495 SW 72ND STREET, SUITE B-295, MIAMI, FL 33173 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-26 | 9495 SW 72ND STREET, SUITE B-295, MIAMI, FL 33173 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-06-23 | GOMEZ, CARLOS C | No data |
| LC NAME CHANGE | 2011-05-04 | CENTER FOR HUMAN FORMATION, LLC | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2013-04-26 |
| LC Amendment and Name Change | 2012-12-26 |
| ANNUAL REPORT | 2012-04-26 |
| ANNUAL REPORT | 2011-06-23 |
| LC Name Change | 2011-05-04 |
| ANNUAL REPORT | 2011-04-29 |
| ANNUAL REPORT | 2010-02-16 |
| Florida Limited Liability | 2009-12-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
