| Entity Name: | TANYA MICKLER, PH.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Dec 2002 (22 years ago) |
| Document Number: | P02000133947 |
| FEI/EIN Number | 141863537 |
| Address: | 2653 SW 87TH DRIVE, SUITE A, GAINESVILLE, FL, 32608, US |
| Mail Address: | 2653 SW 87TH DRIVE, SUITE A, GAINESVILLE, FL, 32608, US |
| ZIP code: | 32608 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356513055 | 2008-04-02 | 2008-04-02 | 4965 SW 91ST TER, SUITE A, GAINESVILLE, FL, 326088149, US | 4965 SW 91ST TER, SUITE A, GAINESVILLE, FL, 326088149, US | |||||||||||||||||||
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| Phone | +1 352-337-0551 |
| Fax | 3523742166 |
Authorized person
| Name | MRS. NORMA BOX |
| Role | OFFICE MANAGER |
| Phone | 3523370551 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY5842 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MICKLER TANYA | Agent | 2653 SW 87TH DR, SUITE A, GAINESVILLE, FL, 32608 |
| Name | Role | Address |
|---|---|---|
| MICKLER TANYA J | President | 10114 SW 38TH PLACE, GAINESVILLE, FL, 32608 |
| Name | Role | Address |
|---|---|---|
| MICKLER JON C | Secretary | 10114 SW 38TH PLACE, GAINESVILLE, FL, 32608 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2009-02-15 | 2653 SW 87TH DRIVE, SUITE A, GAINESVILLE, FL 32608 | No data |
| CHANGE OF MAILING ADDRESS | 2009-02-15 | 2653 SW 87TH DRIVE, SUITE A, GAINESVILLE, FL 32608 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-02-15 | 2653 SW 87TH DR, SUITE A, GAINESVILLE, FL 32608 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-17 |
| ANNUAL REPORT | 2023-04-06 |
| ANNUAL REPORT | 2022-02-26 |
| ANNUAL REPORT | 2021-04-10 |
| ANNUAL REPORT | 2020-02-16 |
| ANNUAL REPORT | 2019-03-27 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-04-09 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-04-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
