| Entity Name: | FLORIDA NEUROCOGNITIVE DEVELOPMENT CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Not For Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Jul 2011 (14 years ago) |
| Date of dissolution: | 30 Dec 2013 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Dec 2013 (11 years ago) |
| Document Number: | N11000006390 |
| FEI/EIN Number | 45-2671133 |
| Address: | 1308 West Sligh Ave, Tampa, FL 33604 |
| Mail Address: | 16105 CADBURY CT., TAMPA, FL 33647 |
| ZIP code: | 33604 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013295450 | 2011-08-03 | 2011-08-03 | 3815 MARYWEATHER LN, SUITE 101, WESLEY CHAPEL, FL, 335447792, US | 3815 MARYWEATHER LN, SUITE 101, WESLEY CHAPEL, FL, 335447792, US | |||||||||||||||||||||||||||
|
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| Phone | +1 813-399-1625 |
| Fax | 8138738837 |
Authorized person
| Name | DR. DIANE ABBY KOCH |
| Role | PRESIDENT |
| Phone | 8133991625 |
Taxonomy
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| License Number | PY4230 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 235Z00000X - Speech-Language Pathologist |
| License Number | SA3850 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| COHEN, ROBERT F | Agent | 2918 BUSCH LAKE BLVD, TAMPA, FL 33614 |
| Name | Role | Address |
|---|---|---|
| KOCH, DIANE A | President | 16105 CADBURY CT., TAMPA, FL 33647 |
| Name | Role | Address |
|---|---|---|
| BOOTH, KIMBERLY K | Vice President | 12308 NORTH PADDOCK AVE., TAMPA, FL 33618 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2013-12-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-26 | 1308 West Sligh Ave, Tampa, FL 33604 | No data |
| Name | Date |
|---|---|
| Voluntary Dissolution | 2013-12-30 |
| ANNUAL REPORT | 2013-04-26 |
| ANNUAL REPORT | 2012-04-12 |
| Domestic Non-Profit | 2011-07-06 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
