| Entity Name: | FLORIDA FORENSIC PSYCHOLOGY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Mar 2010 (15 years ago) |
| Document Number: | P10000024105 |
| FEI/EIN Number | 272135482 |
| Address: | 5190 NW 167th st, Miami Lakes, FL, 33014, US |
| Mail Address: | 5190 NW 167 ST Suite 215, Miami Lakes, FL, 33014, US |
| ZIP code: | 33014 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497283998 | 2017-05-26 | 2017-12-06 | PO BOX 172435, HIALEAH, FL, 330172435, US | 5190 NW 167TH ST STE 215, MIAMI LAKES, FL, 330146338, US | |||||||||||||||||||||||
|
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| Phone | +1 305-456-4147 |
Authorized person
| Name | JOHANNA GUERRERO |
| Role | OWNER |
| Phone | 3054564147 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0217516-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GUERRERO JOHANNA W | Agent | 13001 SW 14th PL, Davie, FL, 33325 |
| Name | Role | Address |
|---|---|---|
| GUERRERO JOHANNA | President | 13001 SW 14th PL, Davie, FL, 33325 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000132580 | COMPANION BEHAVIORAL HEALTH | EXPIRED | 2017-12-05 | 2022-12-31 | No data | 5190 NW 167 ST, SUITE 215, MIAMI LAKES, FL, 33014 |
| G16000033709 | IMMIGRATION FORENSIC PSYCHOLOGY | EXPIRED | 2016-04-02 | 2021-12-31 | No data | 5004 SW 141 AVENUE, MIRAMAR, FL, 33027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-07 | 13001 SW 14th PL, Davie, FL 33325 | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-26 | 5190 NW 167th st, Miami Lakes, FL 33014 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-12 | 5190 NW 167th st, Miami Lakes, FL 33014 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-03-26 | GUERRERO, JOHANNA W | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-03-15 |
| ANNUAL REPORT | 2021-03-20 |
| ANNUAL REPORT | 2020-02-17 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-02-26 |
| ANNUAL REPORT | 2017-02-12 |
| ANNUAL REPORT | 2016-01-18 |
| ANNUAL REPORT | 2015-01-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
