| Entity Name: | COMPREHENSIVE NEUROBEHAVIORAL SERVICES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Nov 2015 (9 years ago) |
| Date of dissolution: | 14 Apr 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 14 Apr 2017 (8 years ago) |
| Document Number: | P15000092225 |
| FEI/EIN Number | 47-5602530 |
| Address: | 2142 ALT. 19, SUITE C1, PALM HARBOR, FL, 34683, US |
| Mail Address: | PO Box 521, Ozona, FL, 34660-0521, US |
| ZIP code: | 34683 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932566882 | 2016-01-23 | 2016-01-23 | 2142 ALT 19, STE C1, PALM HARBOR, FL, 346835361, US | 2142 ALT 19, STE C1, PALM HARBOR, FL, 346835361, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 916-716-9105 |
Authorized person
| Name | SHANNON MARIE FOSTER |
| Role | PRESIDENT |
| Phone | 9167169105 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| License Number | PY 9339 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103TA0700X - Adult Development & Aging Psychologist |
| License Number | PY 9339 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY 9339 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BUCHWALTER RICK AESQ. | Agent | 39780 U.S. HWY 19 NORTH, TARPON SPRINGS, FL, 34689 |
| Name | Role | Address |
|---|---|---|
| FOSTER SHANNON M | President | PO Box 521, Ozona, FL, 346600521 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-04-14 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2016-03-27 | 2142 ALT. 19, SUITE C1, PALM HARBOR, FL 34683 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-03-27 |
| Domestic Profit | 2015-11-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
