| Entity Name: | MINDFUL CONNECTIONS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 26 Mar 2012 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Sep 2017 (7 years ago) |
| Document Number: | L12000042450 |
| FEI/EIN Number | 45-4944552 |
| Address: | 1881 NE 26th Street, Wilton Manors, FL, 33305, US |
| Mail Address: | 733 N.W. 30th Court, WILTON MANORS, FL, 33311, US |
| ZIP code: | 33305 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639582661 | 2014-06-06 | 2014-06-06 | 733 NW 30TH CT, UNIT # 7, WILTON MANORS, FL, 333112400, US | 3042 N FEDERAL HWY, SUITE 207, FORT LAUDERDALE, FL, 333061400, US | |||||||||||||||||||||||
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| Phone | +1 954-770-2363 |
Authorized person
| Name | BENJAMIN D GALLOSO |
| Role | OWNER / PRESIDENT |
| Phone | 9547702363 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | SW8346 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010912100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GALLOSO Benjamin | Agent | 733 N.W. 30th Court, WILTON MANORS, FL, 33311 |
| Name | Role | Address |
|---|---|---|
| GALLOSO Benjamin | Managing Member | 733 N.W. 30th Court, Wilton Manors, FL, 33311 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-21 | 1881 NE 26th Street, Suite 102, Wilton Manors, FL 33305 | No data |
| REINSTATEMENT | 2017-09-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-03-24 | 1881 NE 26th Street, Suite 102, Wilton Manors, FL 33305 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-03-24 | GALLOSO, Benjamin | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-03-24 | 733 N.W. 30th Court, Unit 7, WILTON MANORS, FL 33311 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-04 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-10 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-03-25 |
| ANNUAL REPORT | 2019-03-24 |
| ANNUAL REPORT | 2018-04-28 |
| REINSTATEMENT | 2017-09-29 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-05-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
