| Entity Name: | DEBORAH S. CARLSON, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 05 Aug 2005 (20 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P05000109227 |
| FEI/EIN Number | 203265296 |
| Address: | 12082 LAMONT DR, SPRING HILL, FL, 34608 |
| Mail Address: | 12082 LAMONT DR, SPRING HILL, FL, 34608 |
| ZIP code: | 34608 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982643847 | 2006-06-06 | 2020-08-22 | 5427 COMMERCIAL WAY, SPRING HILL, FL, 34606, US | 5427 COMMERCIAL WAY, SPRING HILL, FL, 34606, US | |||||||||||||||||||||||
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| Phone | +1 352-592-2392 |
| Fax | 3525922394 |
Authorized person
| Name | DEBORAH CARLSON |
| Role | LCSW |
| Phone | 3525922392 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW6456 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | GROUP ID # |
| Number | K9094 |
| Name | Role | Address |
|---|---|---|
| CARLSON DEBORAH S | Agent | 12082 LAMONT DR, SPRING HILL, FL, 34608 |
| Name | Role | Address |
|---|---|---|
| CARLSON DEBORAH S | Director | 12082 LAMONT DR, SPRING HILL, FL, 34608 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-03-20 | 12082 LAMONT DR, SPRING HILL, FL 34608 | No data |
| CHANGE OF MAILING ADDRESS | 2008-03-20 | 12082 LAMONT DR, SPRING HILL, FL 34608 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-03-20 | CARLSON, DEBORAH S | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-03-20 | 12082 LAMONT DR, SPRING HILL, FL 34608 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-03-20 |
| ANNUAL REPORT | 2007-03-29 |
| ANNUAL REPORT | 2006-03-13 |
| Domestic Profit | 2005-08-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
