| Entity Name: | FLORIDA BEHAVIORAL & HEALTH CONSULTANTS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Dec 2007 (17 years ago) |
| Document Number: | P07000129252 |
| FEI/EIN Number | 383775790 |
| Address: | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021, US |
| Mail Address: | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225544232 | 2017-12-28 | 2024-10-23 | 3900 HOLLYWOOD BLVD STE PHE, HOLLYWOOD, FL, 330216760, US | 3900 HOLLYWOOD BLVD STE PHE, HOLLYWOOD, FL, 330216760, US | |||||||||||||||||||||||||||
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| Phone | +1 954-822-4175 |
Authorized person
| Name | DR. PAULENE HAZEL |
| Role | OWNER |
| Phone | 9542924088 |
Taxonomy
| Taxonomy Code | 103TB0200X - Cognitive & Behavioral Psychologist |
| License Number | 0-03-0807 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020188600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAZEL COLIN C | Agent | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Name | Role | Address |
|---|---|---|
| HAZEL PAULENE T | Director | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| HAZEL COLIN C | Director | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Hazel Rachel | Director | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Hazel Robin | Director | 3900 HOLLYWOOD BLVD, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 3900 HOLLYWOOD BLVD, Suite PH E, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 3900 HOLLYWOOD BLVD, Suite PH E, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-01 | 3900 HOLLYWOOD BLVD, Suite PH E, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-06-16 | HAZEL, COLIN C | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-04-09 |
| ANNUAL REPORT | 2022-04-10 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-06-16 |
| ANNUAL REPORT | 2019-03-21 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-03-01 |
| ANNUAL REPORT | 2016-02-28 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
