| Entity Name: | ANDREA VARGAS, LMHC, PL |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 06 Feb 2012 (13 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 02 Mar 2020 (5 years ago) |
| Document Number: | L12000017393 |
| FEI/EIN Number | 45-4465440 |
| Address: | 1535 north park dr, suite 103, WESTON, FL 33326 |
| Mail Address: | 1535 North Park Drive Suite 103, weston, FL 33326 |
| ZIP code: | 33326 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295000362 | 2012-03-21 | 2013-05-07 | 2863 EXECUTIVE PARK DR, STE 106, WESTON, FL, 333313645, US | 2863 EXECUTIVE PARK DR, STE 106, WESTON, FL, 333313645, US | |||||||||||||||||||||||
|
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| Phone | +1 305-338-3537 |
Authorized person
| Name | ANDREA VARGAS |
| Role | OWNER |
| Phone | 3053383537 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH9715 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004126700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VARGAS, ANDREA | Agent | 1535 north park dr, suite 103, WESTON, FL 33326 |
| Name | Role | Address |
|---|---|---|
| VARGAS, ANDREA | Manager | 1535 NORTH PARK DR, SUITE 103 WESTON, FL 33326 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-17 | 1535 north park dr, suite 103, WESTON, FL 33326 | No data |
| CHANGE OF MAILING ADDRESS | 2020-03-10 | 1535 north park dr, suite 103, WESTON, FL 33326 | No data |
| LC STMNT OF RA/RO CHG | 2020-03-02 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-03-02 | 1535 north park dr, suite 103, WESTON, FL 33326 | No data |
| LC STMNT OF RA/RO CHG | 2018-11-29 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-03-14 |
| ANNUAL REPORT | 2022-02-18 |
| ANNUAL REPORT | 2021-05-09 |
| ANNUAL REPORT | 2020-06-10 |
| CORLCRACHG | 2020-03-02 |
| ANNUAL REPORT | 2019-04-17 |
| CORLCRACHG | 2018-11-29 |
| ANNUAL REPORT | 2018-06-28 |
| ANNUAL REPORT | 2017-04-30 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
