| Entity Name: | HERIBERTO M. ORTIZ, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 Jul 2000 (25 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P00000069536 |
| FEI/EIN Number | 651028557 |
| Mail Address: | 7700 N. KENDALL DR., MIAMI, FL, 33156, US |
| Address: | 7700 N. KENDALL DR, MIAMI, FL, 33156, US |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669810933 | 2013-06-10 | 2013-06-10 | 7700 N KENDALL DR, SUITE 415, MIAMI, FL, 331567564, US | 7700 N KENDALL DR, SUITE 415, MIAMI, FL, 331567564, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 305-274-2403 |
| Fax | 3052742433 |
Authorized person
| Name | HERIBERTO M ORTIZ |
| Role | PRESIDENT |
| Phone | 3052742403 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY6187 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TA0400X - Addiction (Substance Use Disorder) Psychologist |
| License Number | 549 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ORTIZ HERIBERTO MDr. | Agent | 13277 NW 10TH ST, MIAMI, FL, 33182238 |
| Name | Role | Address |
|---|---|---|
| ORTIZ MAYDA T | Secretary | 13277 NW 10TH ST, MIAMI, FL, 33182 |
| Name | Role | Address |
|---|---|---|
| ORTIZ HERIBERTO MDr. | President | 13277 NW 10TH ST, MIAMI, FL, 33182238 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-22 | 7700 N. KENDALL DR, STE 415, MIAMI, FL 33156 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-22 | 7700 N. KENDALL DR, STE 415, MIAMI, FL 33156 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-22 | ORTIZ, HERIBERTO M, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-22 | 13277 NW 10TH ST, MIAMI, FL 331822238 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-02-14 |
| ANNUAL REPORT | 2021-04-10 |
| ANNUAL REPORT | 2020-05-07 |
| ANNUAL REPORT | 2019-04-27 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-01-20 |
| ANNUAL REPORT | 2016-02-01 |
| ANNUAL REPORT | 2015-02-27 |
| ANNUAL REPORT | 2014-04-25 |
| ANNUAL REPORT | 2013-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
