| Entity Name: | BROWARD PSYCHOLOGICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 May 2011 (14 years ago) |
| Document Number: | P11000048764 |
| FEI/EIN Number | 45-2495976 |
| Address: | 1961 NW 150th Ave, #103, PEMBROKE PINES, FL 33028 |
| Mail Address: | 1961 NW 150th Ave, #103, PEMBROKE PINES, FL 33028 |
| ZIP code: | 33028 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265895338 | 2016-04-05 | 2016-04-05 | 1941 NW 150TH AVE, SUITE 104, PEMBROKE PINES, FL, 330282874, US | 1941 NW 150TH AVE, SUITE 104, PEMBROKE PINES, FL, 330282874, US | |||||||||||||||
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| Phone | +1 954-374-4747 |
Authorized person
| Name | NICOLA RAJARAM |
| Role | BILLING MANAGER |
| Phone | 9542726723 |
Taxonomy
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, ROSA M | Agent | 1941 NW 150 AVENUE, SUITE 103, PEMBROKE PINES, FL 33028 |
| Name | Role | Address |
|---|---|---|
| NUNEZ, JEANNIE PSY.D. | DIR. | 1961 NW 150th Ave, #103 PEMBROKE PINES, FL 33028 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, ROSA MLMHC | Director | 1961 NW 150th Ave, #103 PEMBROKE PINES, FL 33028 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-05-10 | 1961 NW 150th Ave, #103, PEMBROKE PINES, FL 33028 | No data |
| CHANGE OF MAILING ADDRESS | 2021-05-10 | 1961 NW 150th Ave, #103, PEMBROKE PINES, FL 33028 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-05-10 | 1941 NW 150 AVENUE, SUITE 103, PEMBROKE PINES, FL 33028 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-03-20 | GONZALEZ, ROSA M | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-03-15 |
| AMENDED ANNUAL REPORT | 2021-05-10 |
| ANNUAL REPORT | 2021-03-31 |
| ANNUAL REPORT | 2020-04-01 |
| ANNUAL REPORT | 2019-04-05 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-03-20 |
| AMENDED ANNUAL REPORT | 2016-05-04 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
