| Entity Name: | BRANDON PSYCHIATRIC GROUP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
BRANDON PSYCHIATRIC GROUP LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 07 May 2014 (11 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 13 Dec 2022 (2 years ago) |
| Document Number: | L14000074643 |
| FEI/EIN Number |
APPLIED FOR
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 106 W WINDHORST RD., BRANDON, FL, 33510, US |
| Mail Address: | P.O. Box 1584, Cumming, GA, 30028, US |
| ZIP code: | 33510 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952710147 | 2014-08-13 | 2019-02-06 | PO BOX 1584, CUMMING, GA, 300281584, US | 106 W WINDHORST RD, BRANDON, FL, 335102455, US | |||||||||||||||||||||||||
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| Phone | +1 678-923-6025 |
| Fax | 8134136660 |
Authorized person
| Name | DR. HANY BOTROS MIKHAIL |
| Role | PRESIDENT |
| Phone | 6789236025 |
Taxonomy
| Taxonomy Code | 2084B0040X - Behavioral Neurology & Neuropsychiatry Physician |
| License Number | 95351 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 275940302 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MIKHAIL Hany | Manager | 106 W Windhorst Rd., Brandon, FL, 33510 |
| Mikhail Ihab | Agent | 106 W WINDHORST RD., BRANDON, FL, 33510 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-12-13 | - | - |
| REGISTERED AGENT NAME CHANGED | 2022-12-13 | Mikhail, Ihab | - |
| REGISTERED AGENT ADDRESS CHANGED | 2022-12-13 | 106 W WINDHORST RD., BRANDON, FL 33510 | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-16 | 106 W WINDHORST RD., BRANDON, FL 33510 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-16 | 106 W WINDHORST RD., BRANDON, FL 33510 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-30 |
| ANNUAL REPORT | 2024-03-26 |
| ANNUAL REPORT | 2023-03-08 |
| REINSTATEMENT | 2022-12-13 |
| Reg. Agent Resignation | 2021-10-29 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-01-28 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-03-30 |
| ANNUAL REPORT | 2017-03-14 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4878737400 | 2020-05-11 | 0455 | PPP | 106 W WINDHORST RD, BRANDON, FL, 33511 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 May 2025
Sources: Florida Department of State
