| Entity Name: | SUNTREE PSYCHIATRY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Apr 2004 (21 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P04000063890 |
| FEI/EIN Number | 201016684 |
| Address: | 1331 BEDFORD DRIVE SUITE, 101, MELBOURNE, FL, 32940 |
| Mail Address: | PO BOX 410005, MELBOURNE, FL, 32941 |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326063090 | 2006-07-13 | 2008-04-20 | 1331 BEDFORD DR, SUITE 101, MELBOURNE, FL, 329401987, US | 1331 BEDFORD DR, SUITE 101, MELBOURNE, FL, 329401987, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 321-751-7545 |
| Fax | 3217510311 |
Authorized person
| Name | DR. YANIK LOURDES LUIS-ROIG |
| Role | PRESIDENT |
| Phone | 3217517545 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | ME62778 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 26899 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LUIS-ROIG YANIK | Agent | 1331 BEDFORD DRIVE, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| LUIS-ROIG YANIK M | Director | 1331 BEDFORD DRIVE SUITE 101, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| REINSTATEMENT | 2015-10-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-04-05 | LUIS-ROIG , YANIK | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-19 | 1331 BEDFORD DRIVE SUITE, 101, MELBOURNE, FL 32940 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-05 | 1331 BEDFORD DRIVE, 101, MELBOURNE, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-01 | 1331 BEDFORD DRIVE SUITE, 101, MELBOURNE, FL 32940 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2015-10-26 |
| ANNUAL REPORT | 2014-02-28 |
| ANNUAL REPORT | 2013-04-05 |
| ANNUAL REPORT | 2012-03-19 |
| ANNUAL REPORT | 2011-04-05 |
| ANNUAL REPORT | 2010-04-01 |
| ANNUAL REPORT | 2009-03-28 |
| ANNUAL REPORT | 2008-04-28 |
| ANNUAL REPORT | 2007-04-28 |
| ANNUAL REPORT | 2006-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
