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LISSETTE SELEM, M.D., P.A. - Florida Company Profile

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Company Details

Entity Name: LISSETTE SELEM, M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 07 May 2010 (15 years ago)
Document Number: P10000039931
FEI/EIN Number 272565631
Address: 5803 NW 151 Street Suite 101, Miami Lakes, FL, 33014, US
Mail Address: 1200 LEEWARD WAY, WESTON, FL, 33327
ZIP code: 33014
City: Hialeah
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Selem Lissette President 5803 NW 151 Street Suite 101, Miami Lakes, FL, 33014
SELEM LISSETTE Agent 1200 LEEWARD WAY, WESTON, FL, 33327

National Provider Identifier

NPI Number:
1548673700
Certification Date:
2020-10-09

Authorized Person:

Name:
LISSETTE SALEM
Role:
PHYSICIAN/PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
7865048073

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-01-14 5803 NW 151 Street Suite 101, Miami Lakes, FL 33014 -

Documents

Name Date
ANNUAL REPORT 2025-01-13
ANNUAL REPORT 2024-01-14
ANNUAL REPORT 2023-01-11
ANNUAL REPORT 2022-01-18
ANNUAL REPORT 2021-01-19
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-01-14
ANNUAL REPORT 2018-02-05
ANNUAL REPORT 2017-01-17
ANNUAL REPORT 2016-02-17

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$13,000
Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$13,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$13,162.41
Servicing Lender:
City National Bank of Florida
Use of Proceeds:
Payroll: $9,750
Utilities: $3,250

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Date of last update: 01 Aug 2025

Sources: Florida Department of State