| Entity Name: | BEN C. GHOZALI, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
BEN C. GHOZALI, PSY.D., P.A. 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: | 01 Jun 2009 (16 years ago) |
| Document Number: | P09000047646 |
| FEI/EIN Number |
270396447
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 611 SOUTH MYRTLE AVENUE, CLEARWATER, FL, 33756, US |
| Mail Address: | 611 SOUTH MYRTLE AVENUE, CLEARWATER, FL, 33756, US |
| ZIP code: | 33756 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437388915 | 2009-07-06 | 2024-09-10 | 2843 ALT 19, PALM HARBOR, FL, 346831926, US | 2843 ALT 19, PALM HARBOR, FL, 346831926, US | |||||||||||||||||||||||||
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| Phone | +1 727-772-0038 |
| Fax | 7277872384 |
Authorized person
| Name | DR. BEN GHOZALI |
| Role | PRESIDENT |
| Phone | 8132158348 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY6738 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 73121 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GHOZALI BEN C | President | 1249 Eniswood Pkwy, Palm Harbor, FL, 34683 |
| GHOZALI BEN C | Agent | 611 SOUTH MYRTLE AVENUE, CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-23 | 611 SOUTH MYRTLE AVENUE, Suite B, CLEARWATER, FL 33756 | - |
| CHANGE OF MAILING ADDRESS | 2018-04-23 | 611 SOUTH MYRTLE AVENUE, Suite B, CLEARWATER, FL 33756 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-23 | 611 SOUTH MYRTLE AVENUE, Suite B, CLEARWATER, FL 33756 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-04-11 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-04-12 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-04-24 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5590517704 | 2020-05-01 | 0455 | PPP | 611 S MYRTLE AVE STE B, CLEARWATER, FL, 33756-5666 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Mar 2025
Sources: Florida Department of State
