| Entity Name: | GRANT A. KILLIAN, PH.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 May 2002 (23 years ago) |
| Document Number: | P02000053416 |
| FEI/EIN Number | 421539224 |
| Address: | 2871 NE 30 Street, Lighthouse Point, FL, 33064, US |
| Mail Address: | 2871 NE 30TH STREET, LIGHTHOUSE POINT, FL, 33064 |
| ZIP code: | 33064 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1972560472 | 2006-04-27 | 2011-03-17 | 2871 NE 30TH ST, LIGHTHOUSE POINT, FL, 330648524, US | 950 PENINSULA CORPORATE CIR, STE 1004, BOCA RATON, FL, 334871378, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-786-9000 |
| Fax | 9547829000 |
| Phone | +1 954-360-4200 |
Authorized person
| Name | GRANT ARAM KILLIAN |
| Role | PRESIDENT/OWNER |
| Phone | 9547869000 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103TA0700X - Adult Development & Aging Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TB0200X - Cognitive & Behavioral Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TF0000X - Family Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TP2701X - Group Psychotherapy Psychologist |
| License Number | PY3298 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KILLIAN JANIE | Agent | 2871 NE 30 STREET, LIGHTHOUSE PT., FL, 33064 |
| Name | Role | Address |
|---|---|---|
| KILLIAN GRANT A | Director | 2871 NE 30TH STREET, LIGHTHOUSE POINT, FL, 33064 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-23 | 2871 NE 30 Street, Lighthouse Point, FL 33064 | No data |
| REGISTERED AGENT NAME CHANGED | 2003-04-07 | KILLIAN, JANIE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-04-07 | 2871 NE 30 STREET, LIGHTHOUSE PT., FL 33064 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-02-17 |
| ANNUAL REPORT | 2016-03-01 |
| ANNUAL REPORT | 2015-04-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
