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MIAMI BEHAVIORAL MEDICINE CORP - Florida Company Profile

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Company Details

Entity Name: MIAMI BEHAVIORAL MEDICINE CORP
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 21 Aug 2018 (7 years ago)
Date of dissolution: 27 Sep 2024 (10 months ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (10 months ago)
Document Number: P18000071645
FEI/EIN Number 83-1661574
Address: 2020 PONCE DE LEON BLVD, CORAL GABLES, FL, 33134, US
Mail Address: 2020 PONCE DE LEON BLVD, CORAL GABLES, FL, 33134, US
ZIP code: 33134
City: Miami
County: Miami-Dade
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PEREZ-VERDECIA FRANK R President 2020 PONCE DE LEON BLVD, CORAL GABLES, FL, 33134
CARBONELL MIRTA L Vice President 2020 PONCE DE LEON BLVD, CORAL GABLES, FL, 33134
RIVERA ISIS Administrator 2020 PONCE DE LEON BLVD, CORAL GABLES, FL, 33134
PEREZ-VERDECIA FRANK R Agent 2020 PONCE DE LEON BLVD, CORAL GABLES, FL, 33134

National Provider Identifier

NPI Number:
1063994754
Certification Date:
2021-08-03

Authorized Person:

Name:
DR. FRANK R PEREZ-VERDECIA
Role:
NEUROPSYCHOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
101Y00000X - Counselor
Is Primary:
No
Selected Taxonomy:
103K00000X - Behavior Analyst
Is Primary:
No
Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
No
Selected Taxonomy:
103TR0400X - Rehabilitation Psychologist
Is Primary:
No
Selected Taxonomy:
103G00000X - Clinical Neuropsychologist
Is Primary:
Yes

Contacts:

Fax:
3052201864

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 - -
CHANGE OF PRINCIPAL ADDRESS 2023-04-06 2020 PONCE DE LEON BLVD, SUITE 1201, CORAL GABLES, FL 33134 -
CHANGE OF MAILING ADDRESS 2023-04-06 2020 PONCE DE LEON BLVD, SUITE 1201, CORAL GABLES, FL 33134 -
REGISTERED AGENT ADDRESS CHANGED 2023-04-06 2020 PONCE DE LEON BLVD, SUITE 1201, CORAL GABLES, FL 33134 -

Documents

Name Date
ANNUAL REPORT 2023-04-06
ANNUAL REPORT 2022-04-26
ANNUAL REPORT 2021-02-08
ANNUAL REPORT 2020-01-17
ANNUAL REPORT 2019-04-05
Domestic Profit 2018-08-21

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Date of last update: 02 Jul 2025

Sources: Florida Department of State