| Entity Name: | DOCTORS ISAAC & ISAAC PSYCHIATRIC PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Feb 2022 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 20 Aug 2024 (6 months ago) |
| Document Number: | P22000011134 |
| FEI/EIN Number | 88-0747840 |
| Address: | 3310 CLEVELAND HEIGHTS BLVD., SUITE 203, LAKELAND, FL, 33803, US |
| Mail Address: | 10409 RIVERBURN DR., TAMPA, FL, 33647, US |
| ZIP code: | 33803 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679202618 | 2022-06-06 | 2022-06-06 | 3310 CLEVELAND HEIGHTS BLVD STE 202, LAKELAND, FL, 338034717, US | 3310 CLEVELAND HEIGHTS BLVD STE 202, LAKELAND, FL, 338034717, US | |||||||||||||||||||
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| Phone | +1 718-614-5600 |
| Fax | 7184600802 |
Authorized person
| Name | GEORGE ISSAC |
| Role | OWNER / PROVIDER |
| Phone | 7186145600 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Doctors Isaac and Isaac Psychiatric PA | Agent | 10409 RIVERBURN DR., TAMPA, FL, 33647 |
| Name | Role | Address |
|---|---|---|
| ISAAC GEORGE | President | 3310 CLEVELAND HEIGHTS BLVD. SUITE 203, LAKELAND, FL, 33803 |
| Name | Role | Address |
|---|---|---|
| ISAAC ISAAC G | Vice President | 3310 CLEVELAND HEIGHTS BLVD. SUITE 203, LAKELAND, FL, 33803 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-08-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-08-20 | 3310 CLEVELAND HEIGHTS BLVD., SUITE 203, LAKELAND, FL 33803 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-08-20 | Doctors Isaac and Isaac Psychiatric PA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-08-20 | 10409 RIVERBURN DR., TAMPA, FL 33647 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-08-20 |
| Domestic Profit | 2022-02-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
