| Entity Name: | CINDY JILL NORTH LCSW, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 03 May 2011 (14 years ago) |
| Document Number: | P11000042753 |
| FEI/EIN Number | 90-0739967 |
| Address: | 17900 NW 5th Street, SUITE 203A, PEMBROKE PINES, FL 33029 |
| Mail Address: | 17900 NW 5 St, Suite 203A, PEMBROKE PINES, FL 33029 |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992043657 | 2013-01-30 | 2013-01-30 | 1931 NW 150TH AVE STE 124, PEMBROKE PINES, PEMBROKE PINES, FL, 330282873, US | 1931 NW 150TH AVE STE 124, PEMBROKE PINES, PEMBROKE PINES, FL, 330282873, US | |||||||||||||||||||||||
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| Phone | +1 954-322-1005 |
Authorized person
| Name | MS. CINDY JILL NORTH |
| Role | DIRECTOR |
| Phone | 9543221005 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW3970 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001524800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| JILL NORTH LCSW, CINDY | Agent | 17900 NW 5th Street, Suite 203A, PEMBROKE PINES, FL 33029 |
| Name | Role | Address |
|---|---|---|
| NORTH, CINDY J | Director | 17900, NW 5th Street Suite 203A PEMBROKE PINES, FL 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-03 | JILL NORTH LCSW, CINDY | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-12 | 17900 NW 5th Street, SUITE 203A, PEMBROKE PINES, FL 33029 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-09 | 17900 NW 5th Street, SUITE 203A, PEMBROKE PINES, FL 33029 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-01-09 | 17900 NW 5th Street, Suite 203A, PEMBROKE PINES, FL 33029 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-02-27 |
| ANNUAL REPORT | 2018-01-09 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-01-15 |
Date of last update: 23 Feb 2025
Sources: Florida Department of State
