| Entity Name: | CHILD PROVIDER SPECIALISTS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 08 Dec 2003 (21 years ago) |
| Document Number: | P03000148213 |
| FEI/EIN Number | 20-0487571 |
| Mail Address: | 2771 EXECUTIVE PARK DRIVE, SUITE 6, WESTON, FL 33331 |
| Address: | 2771 EXECUTIVE PARK DRIVE, SUITE 6,7,8, WESTON, FL 33331 |
| ZIP code: | 33331 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942540257 | 2013-02-22 | 2013-02-22 | 2771 EXECUTIVE PARK DR, SUITE #5, WESTON, FL, 333313642, US | 2771 EXECUTIVE PARK DR, SUITE #5, WESTON, FL, 333313642, US | |||||||||||||||||||||||||
|
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| Phone | +1 954-577-3396 |
Authorized person
| Name | DR. MICHAEL PATRICK RIZZO |
| Role | OWNER/LICENSED SCHOOL PSYCHOLOGIST |
| Phone | 9543856292 |
Taxonomy
| Taxonomy Code | 103TC1900X - Counseling Psychologist |
| License Number | SS480 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| License Number | PY5889 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RIZZO, MICHAEL P., Phd | Agent | 2771 EXECUTIVE PARK DRIVE, SUITE 6, WESTON, FL 33331 |
| Name | Role | Address |
|---|---|---|
| RIZZO, MICHAEL P, Phd | PH.D | 2771 EXECUTIVE PARK DRIVE, SUITE 6, Suite 6 WESTON, FL 33331 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000023635 | SOUTH FLORIDA DYSLEXIA INSTITUTE | EXPIRED | 2013-03-08 | 2018-12-31 | No data | 2771 EXECUTIVE PARK DRIVE, SUITE 6, WESTON, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-23 | 2771 EXECUTIVE PARK DRIVE, SUITE 6,7,8, WESTON, FL 33331 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-23 | 2771 EXECUTIVE PARK DRIVE, SUITE 6, WESTON, FL 33331 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-01-09 | RIZZO, MICHAEL P., Phd | No data |
| CHANGE OF MAILING ADDRESS | 2013-01-25 | 2771 EXECUTIVE PARK DRIVE, SUITE 6,7,8, WESTON, FL 33331 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-09 |
Date of last update: 05 Jan 2025
Sources: Florida Department of State
