| Entity Name: | DAVID SHAW, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Oct 2004 (20 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P04000144199 |
| FEI/EIN Number | 201792111 |
| Address: | 825 SO. U.S. HWY 1, SUITE 360A, JUPITER, FL, 33477 |
| Mail Address: | 825 SO. U.S. HWY 1, SUITE 360A, JUPITER, FL, 33477 |
| ZIP code: | 33477 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407046808 | 2007-07-31 | 2007-07-31 | 825 S US HIGHWAY 1, 360, JUPITER, FL, 334775976, US | 825 S US HIGHWAY 1, 360, JUPITER, FL, 334775976, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 561-746-6482 |
| Fax | 5615753662 |
Authorized person
| Name | DR. DAVID SHAW |
| Role | LICENSED PSYCHOLOGIST |
| Phone | 5617466482 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY0003539 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHAW DAVID | Agent | 825 SO. U.S. HWY 1, JUPITER, FL, 33477 |
| Name | Role | Address |
|---|---|---|
| SHAW DAVID | Director | 825 SO. U.S. HWY 1 SUITE 360A, JUPITER, FL, 33477 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-25 |
| ANNUAL REPORT | 2011-04-27 |
| ANNUAL REPORT | 2010-04-24 |
| ANNUAL REPORT | 2009-07-10 |
| ANNUAL REPORT | 2008-04-23 |
| ANNUAL REPORT | 2007-04-05 |
| ANNUAL REPORT | 2006-04-06 |
| ANNUAL REPORT | 2005-04-27 |
| Domestic Profit | 2004-10-19 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
