| Entity Name: | FORT MYERS PSYCHOLOGY, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
FORT MYERS PSYCHOLOGY, PA is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 23 May 2006 (19 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 04 Feb 2021 (4 years ago) |
| Document Number: | P06000072540 |
| FEI/EIN Number |
205066082
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 12791 World Plaza Lane, Bldg 89, FORT MYERS, FL, 33907, US |
| Mail Address: | 8430 BELLE MEADE DRIVE, FORT MYERS, FL, 33908, US |
| ZIP code: | 33907 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003028119 | 2007-05-03 | 2024-02-05 | 8430 BELLE MEADE DR, FORT MYERS, FL, 339086009, US | 12791 WORLD PLAZA LN BLDG 89, FORT MYERS, FL, 339073989, US | |||||||||||||||||||||||||||||
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| Phone | +1 239-826-7903 |
| Fax | 2396454777 |
| Phone | +1 239-829-5494 |
Authorized person
| Name | BRENDA K SLUDER |
| Role | OFFICE BILLING ADMINISTRATOR |
| Phone | 2398876004 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS FLORIDA |
| Number | 74129 |
| State | FL |
| Issuer | BCBS-FL BLUE |
| Number | NJ5TQ |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SPENCER NANCY T | PSYD | 8430 BELLE MEADE DRIVE, FORT MYERS, FL, 33908 |
| SPENCER NANCY TDr. | Agent | 8430 BELLE MEADE DRIVE, FORT MYERS, FL, 33908 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2021-02-04 | FORT MYERS PSYCHOLOGY, PA | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-07 | 12791 World Plaza Lane, Bldg 89, FORT MYERS, FL 33907 | - |
| CHANGE OF MAILING ADDRESS | 2015-02-22 | 12791 World Plaza Lane, Bldg 89, FORT MYERS, FL 33907 | - |
| REGISTERED AGENT NAME CHANGED | 2015-02-22 | SPENCER, NANCY T, Dr. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-22 | 8430 BELLE MEADE DRIVE, FORT MYERS, FL 33908 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-03-11 |
| Name Change | 2021-02-04 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-06-07 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-02-15 |
Date of last update: 01 May 2025
Sources: Florida Department of State
