| Entity Name: | PEACEFUL MIND PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Mar 2014 (11 years ago) |
| Document Number: | L14000046394 |
| FEI/EIN Number | 46-5145611 |
| Address: | 4707 NW 71pl, GAINESVILLE, FL, 32653, US |
| Mail Address: | 4707 NW 71st place, GAINESVILLE, FL, 32653, US |
| ZIP code: | 32653 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295149854 | 2014-06-11 | 2022-01-24 | 4707 NW 71ST PL, GAINESVILLE, FL, 326531155, US | 4635 NW 53RD AVE STE 205, GAINESVILLE, FL, 326533418, US | |||||||||||||||||||||||||||
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| Phone | +1 352-672-6339 |
| Fax | 8338763634 |
Authorized person
| Name | JING LIU |
| Role | OWNER |
| Phone | 3522191624 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPPES |
| Number | 1811172992 |
| State | FL |
| Issuer | NPPES--ORGANIZATIONAL NPI |
| Number | 1295149854 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LIU JING | Agent | 4707 NW 71ST PL, GAINESVILLE, FL, 32653 |
| Name | Role | Address |
|---|---|---|
| LIU JING | Authorized Member | 4707 NW 71ST PL, GAINESVILLE, FL, 32653 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-08 | 4707 NW 71pl, GAINESVILLE, FL 32653 | No data |
| CHANGE OF MAILING ADDRESS | 2015-01-08 | 4707 NW 71pl, GAINESVILLE, FL 32653 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-11 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-21 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-01-13 |
| ANNUAL REPORT | 2016-05-10 |
| ANNUAL REPORT | 2015-01-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
