| Entity Name: | PSYCHIATRIC CARE CONSULTANTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 29 Feb 2012 (13 years ago) |
| Date of dissolution: | 20 Feb 2017 (8 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 20 Feb 2017 (8 years ago) |
| Document Number: | L12000029147 |
| FEI/EIN Number | 45-4667694 |
| Address: | 2316 Hillcrest Street, ORLANDO, FL 32803 |
| Mail Address: | 2316 Hillcrest Street, ORLANDO, FL 32803 |
| ZIP code: | 32803 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407120900 | 2012-03-01 | 2012-03-01 | 2316 HILLCREST ST, ORLANDO, FL, 328034900, US | 2316 HILLCREST ST, ORLANDO, FL, 328034900, US | |||||||||||||||||||
|
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| Phone | +1 407-625-6209 |
Authorized person
| Name | STELLA BANAG MONTES |
| Role | MEDICAL DIRECTOR/OWNER |
| Phone | 4076256209 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 269590100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BELOSO, JUAN | Agent | 14225 LUDGATE HILL LANE, ORLANDO, FL 32828 |
| Name | Role | Address |
|---|---|---|
| MONTES, STELLA | Managing Member | 2316 Hillcrest Street, ORLANDO, FL 32803 |
| Name | Role | Address |
|---|---|---|
| BELOSO, JUAN | Manager | 2316 Hillcrest Street, ORLANDO, FL 32803 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2017-02-20 | No data | No data |
| LC AMENDMENT | 2016-04-20 | No data | No data |
| LC AMENDMENT | 2015-12-21 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-03-22 | 2316 Hillcrest Street, ORLANDO, FL 32803 | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-22 | 2316 Hillcrest Street, ORLANDO, FL 32803 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2017-02-20 |
| ANNUAL REPORT | 2016-07-08 |
| LC Amendment | 2016-04-20 |
| LC Amendment | 2015-12-21 |
| ANNUAL REPORT | 2015-03-16 |
| ANNUAL REPORT | 2014-03-19 |
| ANNUAL REPORT | 2013-03-22 |
| Florida Limited Liability | 2012-02-29 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
