| Entity Name: | NEURO-REHAB PSYCHOLOGY GROUP OF TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Jul 2014 (11 years ago) |
| Document Number: | L14000108562 |
| FEI/EIN Number | 47-1303518 |
| Address: | 5421 Beaumont Center Blvd, Suite 650, Tampa, FL 33634 |
| Mail Address: | 5421 Beaumont Center Blvd, Suite 650, Tampa, FL 33634 |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518373521 | 2014-07-10 | 2016-05-13 | 4400 W SPRUCE ST, #105, TAMPA, FL, 336074149, US | 4400 W SPRUCE ST, 105, TAMPA, FL, 336074149, US | |||||||||||||||||||||||||||||||
|
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| Name | DR. MICHELLE B AYALA-FELICIANO |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 7872494600 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| Is Primary | No |
| Taxonomy Code | 103TB0200X - Cognitive & Behavioral Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 103TF0000X - Family Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TH0100X - Health Service Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TR0400X - Rehabilitation Psychologist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Ayala-Feliciano, Michelle, Dr. | Agent | 5421 Beaumont Center Blvd, Suite 650, Tampa, FL 33634 |
| Name | Role | Address |
|---|---|---|
| Ayala-Feliciano, Michelle | Dr. | 5421 Beaumont Center Blvd, Suite 650 Tampa, FL 33634 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-07 | 5421 Beaumont Center Blvd, Suite 650, Tampa, FL 33634 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-07 | 5421 Beaumont Center Blvd, Suite 650, Tampa, FL 33634 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-07 | 5421 Beaumont Center Blvd, Suite 650, Tampa, FL 33634 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-03-05 | Ayala-Feliciano, Michelle, Dr. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-05-27 |
| ANNUAL REPORT | 2018-03-25 |
| ANNUAL REPORT | 2017-04-21 |
| ANNUAL REPORT | 2016-04-12 |
| ANNUAL REPORT | 2015-04-14 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9061297103 | 2020-04-15 | 0455 | PPP | 6601 Memorial Hwy #218, TAMPA, FL, 33615 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 20 Feb 2025
Sources: Florida Department of State
