| Entity Name: | STEPHEN P. DAVIS, PH.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 26 Dec 2002 (22 years ago) |
| Date of dissolution: | 04 Jan 2011 (14 years ago) |
| Last Event: | VOL DISSOLUTION OF INACTIVE CORP |
| Event Date Filed: | 04 Jan 2011 (14 years ago) |
| Document Number: | P02000134959 |
| FEI/EIN Number | 651166685 |
| Address: | 3173 SE PRUITT RD., PORT ST LUCIE, FL, 34952 |
| Mail Address: | 3173 SE PRUITT RD., PORT ST LUCIE, FL, 34952 |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831123173 | 2006-07-11 | 2020-08-22 | 2400 SE MIDPORT RD, SUITE 211, PORT ST LUCIE, FL, 349524823, US | 2400 SE MIDPORT RD, SUITE 211, PORT ST LUCIE, FL, 349524823, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-398-1003 |
| Fax | 7723981772 |
Authorized person
| Name | DR. STEPHEN P. DAVIS |
| Role | PRESIDENT |
| Phone | 7723981003 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY 5785 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | VALUE OPTIONS |
| Number | 125175 |
| State | FL |
| Issuer | AETNA |
| Number | 10745971 |
| State | FL |
| Issuer | CIGNA |
| Number | 82322 |
| State | FL |
| Issuer | MAGELLAN |
| Number | IP029180 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DAVIS STEPHEN P | Agent | 3173 SE PRUITT RD., PORT ST LUCIE, FL, 34952 |
| Name | Role | Address |
|---|---|---|
| DAVIS STEPHEN P | President | 3173 SE PRUITT RD., PORT ST. LUCIE, FL, 34952 |
| Name | Role | Address |
|---|---|---|
| DAVIS STEPHEN P | Secretary | 3173 SE PRUITT RD., PORT ST. LUCIE, FL, 34952 |
| Name | Role | Address |
|---|---|---|
| DAVIS STEPHEN P | Treasurer | 3173 SE PRUITT RD., PORT ST. LUCIE, FL, 34952 |
| Name | Role | Address |
|---|---|---|
| DAVIS STEPHEN P | Director | 3173 SE PRUITT RD., PORT ST. LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOL DISSOLUTION OF INACTIVE CORP | 2011-01-04 | No data | NOTICE OF DISSOLUTION |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-29 | 3173 SE PRUITT RD., PORT ST LUCIE, FL 34952 | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-29 | 3173 SE PRUITT RD., PORT ST LUCIE, FL 34952 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-29 | 3173 SE PRUITT RD., PORT ST LUCIE, FL 34952 | No data |
| Name | Date |
|---|---|
| Vol. Diss. of Inactive Corp. | 2011-01-04 |
| ANNUAL REPORT | 2009-01-28 |
| ANNUAL REPORT | 2008-04-29 |
| ANNUAL REPORT | 2007-04-18 |
| ANNUAL REPORT | 2006-02-16 |
| ANNUAL REPORT | 2005-02-16 |
| ANNUAL REPORT | 2004-06-07 |
| ANNUAL REPORT | 2003-03-31 |
| Domestic Profit | 2002-12-26 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
