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NORTHEAST FLORIDA PSYCHIATRIC ASSOCIATION, INC. - Florida Company Profile

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Company Details

Entity Name: NORTHEAST FLORIDA PSYCHIATRIC ASSOCIATION, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 24 Jul 2013 (12 years ago)
Document Number: P13000062283
FEI/EIN Number 463384281
Address: 804 Dunlawton Avenue, PORT ORANGE, FL, 32127, US
Mail Address: 804 Dunlawton Avenue, PORT ORANGE, FL, 32127, US
ZIP code: 32127
City: Port Orange
County: Volusia
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
FRICK ROSALYN President 804 Dunlawton Avenue, PORT ORANGE, FL, 32127
FRICK ROSALYN Secretary 804 Dunlawton Avenue, PORT ORANGE, FL, 32127
Friebis Daniel S Agent 3890 Turtle Creek Drive, Port Orange, FL, 32127

National Provider Identifier

NPI Number:
1558798405
Certification Date:
2025-03-05

Authorized Person:

Name:
DR. GARY W FRICK
Role:
PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
3867678536

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2020-01-29 Friebis, Daniel S -
REGISTERED AGENT ADDRESS CHANGED 2020-01-29 3890 Turtle Creek Drive, Suite B, Port Orange, FL 32127 -
CHANGE OF PRINCIPAL ADDRESS 2016-03-30 804 Dunlawton Avenue, Unit 1, PORT ORANGE, FL 32127 -
CHANGE OF MAILING ADDRESS 2016-03-30 804 Dunlawton Avenue, Unit 1, PORT ORANGE, FL 32127 -

Documents

Name Date
ANNUAL REPORT 2024-04-05
ANNUAL REPORT 2023-02-07
ANNUAL REPORT 2022-04-12
ANNUAL REPORT 2021-04-23
ANNUAL REPORT 2020-01-29
ANNUAL REPORT 2019-02-02
ANNUAL REPORT 2018-01-12
ANNUAL REPORT 2017-01-20
ANNUAL REPORT 2016-03-30
ANNUAL REPORT 2015-03-02

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Date of last update: 02 Aug 2025

Sources: Florida Department of State