| Entity Name: | BAYSIDE NEUROTHERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 29 May 2018 (7 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 04 Jun 2018 (7 years ago) |
| Document Number: | L18000132391 |
| FEI/EIN Number | 83-0766225 |
| Address: | 1022 W 23RD ST, SUITE 530, PANAMA CITY, FL 32405 |
| Mail Address: | 1022 W 23RD ST, SUITE 530, PANAMA CITY, FL 32405 |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043785926 | 2018-10-08 | 2018-10-08 | 1022 W 23RD ST STE 530, PANAMA CITY, FL, 324053688, US | 1022 W 23RD ST STE 530, PANAMA CITY, FL, 324053688, US | |||||||||||||||
|
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| Phone | +1 850-541-8520 |
| Fax | 8505419928 |
Authorized person
| Name | DR. CYNTHIA LEIGH WILSON |
| Role | LICENSED CLINICAL PSYCHOLOGIST |
| Phone | 8505418520 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILSON, CYNTHIA L | Agent | 1022 W 23RD ST, SUITE 530, PANAMA CITY, FL 32405 |
| Name | Role | Address |
|---|---|---|
| WILSON, CYNTHIA L | Authorized Representative | 1022 W 23RD ST, SUITE 530 PANAMA CITY, FL 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-01-21 | 1022 W 23RD ST, SUITE 530, PANAMA CITY, FL 32405 | No data |
| LC STMNT OF RA/RO CHG | 2018-06-04 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-06-04 | 1022 W 23RD ST, SUITE 530, PANAMA CITY, FL 32405 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-05-31 | 1022 W 23RD ST, SUITE 530, PANAMA CITY, FL 32405 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-02-22 |
| CORLCRACHG | 2018-06-04 |
| Florida Limited Liability | 2018-05-29 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
