| Entity Name: | APPLIED BEHAVIORAL INTERVENTION THERAPY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Jul 2024 (6 months ago) |
| Document Number: | P24000048071 |
| Address: | 3495 N. HIATUS ROAD, SUNRISE, FL, 33351, UN |
| Mail Address: | 3495 N. HIATUS ROAD, SUNRISE, FL, 33351, UN |
| ZIP code: | 33351 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477380491 | 2024-09-14 | 2024-09-14 | 3495 N HIATUS RD, SUNRISE, FL, 333517516, US | 3495 N HIATUS RD, SUNRISE, FL, 333517516, US | |||||||||||||
|
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| Phone | +1 954-749-6869 |
Authorized person
| Name | ROBERT B SAMAREL |
| Role | VICE PRESIDENT |
| Phone | 5618271850 |
Taxonomy
| Taxonomy Code | 2080P0006X - Developmental - Behavioral Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SAMAREL ROBERT | Agent | 11658 SW 50TH AVE, OCALA, FL, 34476-874 |
| Name | Role | Address |
|---|---|---|
| GIL SHIRLEY | President | 4909 NW 92 AVE, SUNRISE, FL, 33351 |
| Name | Role | Address |
|---|---|---|
| SAMAREL ROBERT | Vice President | 11658 SW 50TH AVE, OCALA, FL, 34476-874 |
| Name | Role | Address |
|---|---|---|
| SAMAREL ROBERT | Secretary | 11658 SW 50TH AVE, OCALA, FL, 34476-874 |
| Name | Date |
|---|---|
| Domestic Profit | 2024-07-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
