| Entity Name: | MINDFUL INTEGRATED MEDICINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 Dec 2015 (9 years ago) |
| Date of dissolution: | 18 Nov 2019 (5 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 18 Nov 2019 (5 years ago) |
| Document Number: | L15000207594 |
| FEI/EIN Number | 81-0853016 |
| Address: | 711 E. OAK STREET, KISSIMMEE, FL, 34744, US |
| Mail Address: | 711 E. OAK STREET, KISSIMMEE, FL, 34744, US |
| ZIP code: | 34744 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831544832 | 2016-04-27 | 2016-10-04 | 719 E OAK ST, KISSIMMEE, FL, 347444580, US | 711 E OAK ST, KISSIMMEE, FL, 347444573, US | |||||||||||||||||||||||||||
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| Phone | +1 407-846-0533 |
| Fax | 4075181730 |
Authorized person
| Name | MS. IVETTE A CHARNECO |
| Role | OFFICE ADMINISTRATOR |
| Phone | 4078460533 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CHARNECO VIVIAN MD | Agent | 711 E. OAK STREET, KISSIMMEE, FL, 34744 |
| Name | Role | Address |
|---|---|---|
| CHARNECO VIVIAN MD | Manager | 711 E. OAK STREET, KISSIMMEE, FL, 34744 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2019-11-18 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-26 | 711 E. OAK STREET, KISSIMMEE, FL 34744 | No data |
| LC AMENDMENT | 2016-11-09 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-11-09 | 711 E. OAK STREET, KISSIMMEE, FL 34744 | No data |
| CHANGE OF MAILING ADDRESS | 2016-11-09 | 711 E. OAK STREET, KISSIMMEE, FL 34744 | No data |
| LC NAME CHANGE | 2016-08-25 | MINDFUL INTEGRATED MEDICINE, LLC | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2019-11-18 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-04-19 |
| ANNUAL REPORT | 2017-04-19 |
| LC Amendment | 2016-11-09 |
| LC Name Change | 2016-08-25 |
| ANNUAL REPORT | 2016-04-26 |
| Florida Limited Liability | 2015-12-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
