| Entity Name: | MIAMI PERSONAL BEHAVIORAL LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Jul 2010 (15 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 18 Sep 2023 (a year ago) |
| Document Number: | L10000079366 |
| FEI/EIN Number | 273314213 |
| Address: | 3611 SW 107TH AVE, MIAMI, FL, 33165, US |
| Mail Address: | 3611 SW 107TH AVE, MIAMI, FL, 33165, US |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104366160 | 2017-02-24 | 2022-02-17 | 3611 SW 107TH AVE, MIAMI, FL, 331653636, US | 3611 SW 107TH AVE, MIAMI, FL, 331653636, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 305-223-2618 |
Authorized person
| Name | MRS. YADIRA AMARAL |
| Role | MEMBER |
| Phone | 3053054025 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003156900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AMARAL YADIRA | Agent | 3611 SW 107 AVENUE, MIAMI, FL, 33165 |
| Name | Role | Address |
|---|---|---|
| AMARAL YADIRA | Authorized Person | 3611 SW 107TH AVE, MIAMI, FL, 33165 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000002972 | SYX | EXPIRED | 2013-01-09 | 2018-12-31 | No data | 7575 WEST FLAGLER ST., SUITE 200, MIAMI, FL, 33144, US |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2023-09-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-09-18 | AMARAL, YADIRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-09-18 | 3611 SW 107 AVENUE, MIAMI, FL 33165 | No data |
| LC AMENDMENT | 2018-02-12 | No data | No data |
| LC NAME CHANGE | 2017-02-21 | MIAMI PERSONAL BEHAVIORAL LLC | No data |
| LC AMENDMENT | 2010-08-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-05 |
| LC Amendment | 2023-09-18 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-03-31 |
| ANNUAL REPORT | 2020-04-17 |
| ANNUAL REPORT | 2019-02-06 |
| LC Amendment | 2018-02-12 |
| ANNUAL REPORT | 2018-01-16 |
| AMENDED ANNUAL REPORT | 2017-03-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
