| Entity Name: | DAVID S. BUSH, PH.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 12 Dec 1996 (28 years ago) |
| Document Number: | P96000100522 |
| FEI/EIN Number | 65-0723452 |
| Address: | 11211 PROSPERITY FARMS, STE. C-206, PALM BCH GARDENS, FL 33410 |
| Mail Address: | 11211 PROSPERITY FARMS, STE. C-206, PALM BCH GARDENS, FL 33410 |
| ZIP code: | 33410 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740540046 | 2012-05-21 | 2012-05-21 | 11211 PROSPERITY FARMS RD, SUITE C206, PALM BEACH GARDENS, FL, 334103446, US | 11211 PROSPERITY FARMS RD, SUITE C206, PALM BEACH GARDENS, FL, 334103446, US | |||||||||||||||||||
|
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| Phone | +1 561-622-8881 |
| Fax | 5616228018 |
Authorized person
| Name | DR. DAVID S BUSH |
| Role | PRESIDENT |
| Phone | 5616228881 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| License Number | PY003425 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BUSH, DAVID S | Agent | 11211 PROSPERITY FARMS ROAD, C206, PALM BEACH GARDENS, FL 33410 |
| Name | Role | Address |
|---|---|---|
| BUSH, DAVID S | Director | 11211 PROSPERITY FARMS ROAD, PALM BEACH GARDENS, FL 33410 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-04 | 11211 PROSPERITY FARMS ROAD, C206, PALM BEACH GARDENS, FL 33410 | No data |
| CHANGE OF MAILING ADDRESS | 2000-04-11 | 11211 PROSPERITY FARMS, STE. C-206, PALM BCH GARDENS, FL 33410 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1998-01-23 | 11211 PROSPERITY FARMS, STE. C-206, PALM BCH GARDENS, FL 33410 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-05 |
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-03 |
| ANNUAL REPORT | 2022-01-04 |
| ANNUAL REPORT | 2021-01-04 |
| ANNUAL REPORT | 2020-01-02 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-01-01 |
| ANNUAL REPORT | 2017-01-06 |
| ANNUAL REPORT | 2016-01-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
