| Entity Name: | DR. CARLOS C. GOMEZ & ASSOCIATES, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 May 2012 (13 years ago) |
| Date of dissolution: | 28 Dec 2017 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 28 Dec 2017 (7 years ago) |
| Document Number: | P12000048982 |
| FEI/EIN Number | 46-1560735 |
| Address: | DBA CENTER FOR HUMAN FORMATION, 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL, 33146, US |
| Mail Address: | DBA CENTER FOR HUMAN FORMATION, 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL, 33146, US |
| ZIP code: | 33146 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932534666 | 2013-09-12 | 2013-09-12 | 9495 SW 72ND AVENUE, SUITE B295, MIAMI, FL, 33146, US | 9495 SW 72ND AVENUE, SUITE B295, MIAMI, FL, 33173, US | |||||||||||||||||||
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| Phone | +1 786-879-7007 |
| Fax | 7862213978 |
Authorized person
| Name | DR. CARLOS CAMILO GOMEZ |
| Role | PSYCHOLOGIST /OWNER |
| Phone | 7868797007 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY7327 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOMEZ CARLOS CPHD | Agent | 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL, 33146 |
| Name | Role | Address |
|---|---|---|
| GOMEZ CARLOS CPHD | President | 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL, 33146 |
| Name | Role | Address |
|---|---|---|
| GOMEZ HOLLY E | Authorized Person | C/O DR. CARLOS C GOMEZ & ASSOCIATES, CORAL GABLES, FL, 33146 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000087519 | CENTER FOR HUMAN FORMATION | EXPIRED | 2014-08-26 | 2019-12-31 | No data | 1172 SOUTH DIXIE HIGHWAY #437, CORAL GABLES, FL, 33146 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-12-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-30 | DBA CENTER FOR HUMAN FORMATION, 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL 33146 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-11-25 | DBA CENTER FOR HUMAN FORMATION, 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL 33146 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-11-25 | 1390 S DIXIE HWY STE 2107, CORAL GABLES, FL 33146 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-01-31 | GOMEZ, CARLOS C, PHD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-04 |
| ANNUAL REPORT | 2016-01-13 |
| ANNUAL REPORT | 2015-01-30 |
| AMENDED ANNUAL REPORT | 2014-11-25 |
| ANNUAL REPORT | 2014-02-26 |
| ANNUAL REPORT | 2013-01-31 |
| Domestic Profit | 2012-05-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
