| Entity Name: | BREVARD NEURO CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Sep 2013 (11 years ago) |
| Document Number: | L13000131036 |
| FEI/EIN Number | 46-3828714 |
| Mail Address: | 315 E Nasa Blvd, MELBOURNE, FL, 32901, US |
| Address: | 315 E NASA BLVD, MELBOURNE, FL, 32901 |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801224290 | 2013-10-22 | 2014-09-29 | 315 E NASA BLVD, MELBOURNE, FL, 329011939, US | 315 E NASA BLVD, MELBOURNE, FL, 329011939, US | |||||||||||||||||||
|
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| Phone | +1 321-733-2711 |
| Fax | 3217332011 |
Authorized person
| Name | JOSSE ANTHONY MAZO-MAYORQUIN |
| Role | MD/OWNER |
| Phone | 3217332711 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME89659 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MAZO ANTHONY | Agent | 6331 PORTOFINO LANE, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| MAZO ANTHONY | Managing Member | 6331 PORTOFINO LANE, MELBOURNE, FL, 32940 |
| RIASCOS MARITZA | Managing Member | 6331 PORTOFINO LANE, MELBOURNE, FL, 32940 |
| MAZO JOSSE A | Managing Member | 6331 PORTOFINO LANE, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2015-01-08 | 315 E NASA BLVD, MELBOURNE, FL 32901 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-19 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-03-10 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
