| Entity Name: | PRIVATE PSYCHIATRY OF SOUTH WEST FLORIDA, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 May 2016 (9 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P16000044882 |
| FEI/EIN Number | 81-3026977 |
| Address: | 5454 LENA RD., STE.106, BRADENTON, FL, 34211, US |
| Mail Address: | 5454 LENA RD., STE.106, BRADENTON, FL, 34211, US |
| ZIP code: | 34211 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811432610 | 2017-01-03 | 2017-03-23 | 5454 LENA RD, SUITE 106, BRADENTON, FL, 342119499, US | 5454 LENA RD, SUITE 106, BRADENTON, FL, 342119499, US | |||||||||||||||||||
|
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| Phone | +1 941-900-1111 |
| Fax | 9412014856 |
Authorized person
| Name | KEVIN CASE |
| Role | PRESIDENT |
| Phone | 9419001111 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| License Number | ARNP9276826 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CASE CAROLYN | Agent | 5454 LENA RD., BRADENTON, FL, 34211 |
| Name | Role | Address |
|---|---|---|
| CASE CAROLYN | President | 5454 LENA RD. SUITE #106, BRADENTON, FL, 34211 |
| Name | Role | Address |
|---|---|---|
| CASE CAROLYN | Director | 5454 LENA RD. SUITE #106, BRADENTON, FL, 34211 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| AMENDMENT | 2017-06-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-06-05 | CASE, CAROLYN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-06-05 | 5454 LENA RD., BRADENTON, FL 34211 | No data |
| Name | Date |
|---|---|
| Amendment | 2017-06-05 |
| ANNUAL REPORT | 2017-03-07 |
| Domestic Profit | 2016-05-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
