Entity Name: | FAMILY PSYCHOLOGICAL SERVICES OF PALM HARBOR, INC. |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Active |
Date Filed: | 26 Jan 1999 (26 years ago) |
Document Number: | P99000007321 |
FEI/EIN Number | 593556696 |
Address: | 2142 US HIGHWAY ALT 19 N., SUITE C-1, PALM HARBOR, FL, 34683, US |
Mail Address: | 2142 US HIGHWAY ALT 19 N., C-1, PALM HARBOR, FL, 34683, US |
ZIP code: | 34683 |
County: | Pinellas |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1639203763 | 2007-03-14 | 2024-01-23 | 2142 ALT 19 STE C1, PALM HARBOR, FL, 346835361, US | 2142 ALT 19 STE C1, PALM HARBOR, FL, 346835361, US | |||||||||||||||||||||||
|
Phone | +1 727-787-6177 |
Fax | 7277878406 |
Authorized person
Name | DR. ERIC L ROSEN |
Role | OWNER & PRESIDENT |
Phone | 7277876177 |
Taxonomy
Taxonomy Code | 103T00000X - Psychologist |
License Number | PY5165 |
State | FL |
Is Primary | Yes |
Taxonomy Code | 103TC0700X - Clinical Psychologist |
Is Primary | No |
Name | Role | Address |
---|---|---|
ROSEN ERIC L | Agent | 2358 LANDING WAY, PALM HARBOR, FL, 34684 |
Name | Role | Address |
---|---|---|
Rosen Eric L | Owne | 2358 Landing Way, Palm Harbor, FL, 34684 |
Name | Role | Address |
---|---|---|
Rosen Barbara | Vice President | 2358 Landing Way, Palm Harbor, FL, 34684 |
Name | Role | Address |
---|---|---|
Rosen Robert | Chief Executive Officer | 9721 Montague Street, Westchase, FL, 33626 |
Name | Role | Address |
---|---|---|
Rosen Karon | Clin | 9721 Montague Street, Westchase, FL, 33626 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
REGISTERED AGENT ADDRESS CHANGED | 2025-01-27 | 2142 US HIGHWAY ALT 19 N., SUITE C-1, PALM HARBOR, FL 34683 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2013-01-22 | 2142 US HIGHWAY ALT 19 N., SUITE C-1, PALM HARBOR, FL 34683 | No data |
CHANGE OF MAILING ADDRESS | 2013-01-22 | 2142 US HIGHWAY ALT 19 N., SUITE C-1, PALM HARBOR, FL 34683 | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2025-01-27 |
ANNUAL REPORT | 2024-01-25 |
ANNUAL REPORT | 2023-03-10 |
ANNUAL REPORT | 2022-01-26 |
ANNUAL REPORT | 2021-03-15 |
ANNUAL REPORT | 2020-01-17 |
ANNUAL REPORT | 2019-01-28 |
ANNUAL REPORT | 2018-02-02 |
ANNUAL REPORT | 2017-01-11 |
ANNUAL REPORT | 2016-01-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State