| Entity Name: | DAVID BOLTSON, PSY.D, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Jan 2000 (25 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 14 Oct 2009 (15 years ago) |
| Document Number: | P00000000571 |
| FEI/EIN Number | 651070761 |
| Mail Address: | 6300 Hatteras Club Drive, Lake Worth, FL, 33463, US |
| Address: | 1375 GATEWAY BLVD, Suite 31, BOYNTON BEACH, FL, 33426, US |
| ZIP code: | 33426 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417100835 | 2008-10-29 | 2024-06-04 | 6300 HATTERAS CLUB DR, LAKE WORTH, FL, 334636539, US | 1375 GATEWAY BLVD STE 31, BOYNTON BEACH, FL, 334268304, US | |||||||||||||||||
|
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| Phone | +1 561-718-9590 |
| Fax | 5615705999 |
| Phone | +1 561-649-3309 |
Authorized person
| Name | DR. DAVID BOLTSON |
| Role | PSYCHOLOGIST |
| Phone | 5616493309 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BOLTSON DAVID C | Agent | 6300 HATTERAS CLUB DR, Lake Worth, FL, 33463 |
| Name | Role | Address |
|---|---|---|
| BOLTSON DAVID DR. | President | 1375 GATEWAY BLVD, BOYNTON BEACH, FL, 33426 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-30 | 1375 GATEWAY BLVD, Suite 31, BOYNTON BEACH, FL 33426 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-30 | 6300 HATTERAS CLUB DR, Lake Worth, FL 33463 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-30 | 1375 GATEWAY BLVD, Suite 31, BOYNTON BEACH, FL 33426 | No data |
| CANCEL ADM DISS/REV | 2009-10-14 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2008-10-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2005-05-08 | BOLTSON, DAVID CEO | No data |
| CANCEL ADM DISS/REV | 2004-10-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-03-30 |
| ANNUAL REPORT | 2020-03-12 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-31 |
| ANNUAL REPORT | 2017-05-08 |
| ANNUAL REPORT | 2016-08-05 |
| ANNUAL REPORT | 2015-04-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
