| Entity Name: | TAMPA BAY INSTITUTE FOR PSYCHOLOGICAL AND BEHAVIORAL HEALTH , P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 May 2019 (6 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 06 Dec 2021 (3 years ago) |
| Document Number: | P19000040804 |
| FEI/EIN Number | 84-1785780 |
| Address: | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638, US |
| Mail Address: | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638, US |
| ZIP code: | 34638 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275191330 | 2019-06-04 | 2022-02-03 | 20747 STERLINGTON DR, LAND O LAKES, FL, 346384317, US | 20747 STERLINGTON DR, LAND O LAKES, FL, 346384317, US | |||||||||||||||||
|
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| Phone | +1 813-907-9191 |
| Fax | 8139480094 |
| Phone | +1 813-635-6350 |
Authorized person
| Name | DR. DAVID ALEXANDER |
| Role | PSYCHOLOGIST |
| Phone | 8136356350 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Alexander David | Agent | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638 |
| Name | Role | Address |
|---|---|---|
| ALEXANDER DAVID PSY.D. | CO | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638 |
| ALEXANDER NICOLE Psy.D. | CO | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638 |
| Name | Role | Address |
|---|---|---|
| ALEXANDER DAVID PSY.D. | President | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638 |
| ALEXANDER NICOLE Psy.D. | President | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL, 34638 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT AND NAME CHANGE | 2021-12-06 | TAMPA BAY INSTITUTE FOR PSYCHOLOGICAL AND BEHAVIORAL HEALTH , P.A. | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-08 | Alexander, David | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-08 | 20747 STERLINGTON DRIVE, LAND O'LAKES, FL 34638 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-03-18 |
| Amendment and Name Change | 2021-12-06 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-02-08 |
| Domestic Profit | 2019-05-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
