| Entity Name: | SUNCOAST BEHAVIORAL MEDICINE, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Jan 2005 (20 years ago) |
| Document Number: | P05000002813 |
| FEI/EIN Number | 202132614 |
| Address: | 4456 S DIAMOND CIR S, Sarasota, FL, 34233, US |
| Mail Address: | 4456 S DIAMOND CIR S, Sarasota,FL, FL, 34233, US |
| ZIP code: | 34233 |
| County: | Sarasota |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306993654 | 2007-01-05 | 2020-08-22 | 4370 S TAMIAMI TRL, SUITE 241, SARASOTA, FL, 342313412, US | 4370 S TAMIAMI TRL, SUITE 241, SARASOTA, FL, 342313412, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-926-2474 |
| Fax | 9419262440 |
Authorized person
| Name | DR. WILLIAM BAKER |
| Role | PRESIDENT |
| Phone | 9419262474 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH4720 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY 5729 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT13914 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BAKER WILLIAM K | Agent | 4456 S DIAMOND CIR S, Sarasota,FL, FL, 34233 |
| Name | Role | Address |
|---|---|---|
| BAKER WILLIAM K | President | 4456 S DIAMOND CIR S, Sarasota, FL, 34233 |
| Name | Role | Address |
|---|---|---|
| BAKER JOANNA R | Vice President | 4456 S DIAMOND CIR S, Sarasota, FL, 34233 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-20 | 4456 S DIAMOND CIR S, Sarasota, FL 34233 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-15 | 4456 S DIAMOND CIR S, Sarasota, FL 34233 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-15 | 4456 S DIAMOND CIR S, Sarasota,FL, FL 34233 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-20 |
| ANNUAL REPORT | 2023-04-15 |
| ANNUAL REPORT | 2022-04-13 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-06-05 |
| ANNUAL REPORT | 2019-04-29 |
| ANNUAL REPORT | 2018-04-11 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-04-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
