| Entity Name: | DAVID S HOLLAND, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 07 Jul 2011 (14 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P11000061868 |
| FEI/EIN Number | 45-2692018 |
| Address: | 1300 N FEDERAL HWY, 206, BOCA RATON, FL 33432 |
| Mail Address: | 1300 N FEDERAL HWY, 206, BOCA RATON, FL 33432 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528348471 | 2011-08-24 | 2021-01-18 | 1031 ROYAL PALM BLVD, VERO BEACH, FL, 329605341, US | 1300 N FEDERAL HWY STE 206, BOCA RATON, FL, 334322848, US | |||||||||||||||||||||||||
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| Phone | +1 561-338-9898 |
| Fax | 5613922122 |
Authorized person
| Name | DR. DAVID S HOLLAND |
| Role | PSY.D. |
| Phone | 5613389898 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY6078 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | E3831 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HOLLAND, DAVID S | Agent | 3700 GALT OCEAN DR, 304, FT. LAUDERDALE, FL 33308 |
| Name | Role | Address |
|---|---|---|
| HOLLAND, DAVID S | President | 3700 GALT OCEAN DR #304, FT LAUDERDALE, FL 33308 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REINSTATEMENT | 2013-10-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-27 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-28 |
| ANNUAL REPORT | 2012-03-21 |
| Domestic Profit | 2011-07-07 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
