| Entity Name: | THERESA M HENDERSON, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 29 Mar 2024 (a year ago) |
| Document Number: | P24000022150 |
| Address: | FILED IN ERROR(SEE:L24000170330), X |
| Mail Address: | FILED IN ERROR(SEE:L24000170330), X |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982979662 | 2012-03-14 | 2012-03-28 | 9609 WOODBAY DR, TAMPA, FL, 336262422, US | 1210 MILLENNIUM PKWY, SUITE 1035, BRANDON, FL, 335114861, US | |||||||||||||||||||
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| Phone | +1 813-716-0585 |
| Fax | 8138140448 |
Authorized person
| Name | MS. THERESA M HENDERSON |
| Role | PRESIDENT |
| Phone | 8137160585 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW2072 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HENDERSON THERESA M | Agent | 9609 WOODBAY DR, TAMPA, FL33626 |
| Name | Role | Address |
|---|---|---|
| HENDERSON THERESA M | Authorized Member | 9609 WOODBAY DR, TAMPA, FL33626 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CONVERSION | 2024-03-05 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P06000008725. CONVERSION NUMBER 900000251599 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-03-29 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
