| Entity Name: | T BOLAND ARNP LMFT PHDC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 31 Aug 2005 (19 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P05000121489 |
| FEI/EIN Number | 203393625 |
| Address: | 525 N Ocean Blvd, Pompano Beach, FL, 33062, US |
| Mail Address: | PO Box 22-2703, PMB 186, Hollywood, FL, 33022, US |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114988607 | 2006-04-01 | 2020-08-22 | 1112 WESTON RD, PMB 186, WESTON, FL, 33326, US | 555 SW 148TH AVE, STE 130, SUNRISE, FL, 33325, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 954-577-0008 |
| Fax | 9545770339 |
Authorized person
| Name | MS. TERESA MARIE BOLAND |
| Role | OWNER |
| Phone | 9545770008 |
Taxonomy
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| License Number | MT1542 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 163W00000X - Registered Nurse |
| License Number | ARNP1838792 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0344908900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BOLAND T. | Agent | 1112 WESTON ROAD, WESTON, FL, 33326 |
| Name | Role | Address |
|---|---|---|
| BOLAND T | Manager | 1112 WESTON ROAD PMB186, WESTON, FL, 33326 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-12-01 | 525 N Ocean Blvd, APT. 1121, Pompano Beach, FL 33062 | No data |
| CHANGE OF MAILING ADDRESS | 2021-12-01 | 525 N Ocean Blvd, APT. 1121, Pompano Beach, FL 33062 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-04-20 |
| ANNUAL REPORT | 2009-04-29 |
| ANNUAL REPORT | 2008-04-09 |
| ANNUAL REPORT | 2007-04-24 |
| ANNUAL REPORT | 2006-04-21 |
| Domestic Profit | 2005-08-31 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
