| Entity Name: | POSITIVE MINDSET GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Oct 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Oct 2021 (3 years ago) |
| Document Number: | L19000266525 |
| FEI/EIN Number | 84-3490261 |
| Address: | 4735 Old Canoe Creek Rd., SAINT CLOUD, FL, 34769, US |
| Mail Address: | 4735 Old Canoe Creek Rd., SAINT CLOUD, FL, 34769, US |
| ZIP code: | 34769 |
| County: | Osceola |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982225595 | 2020-05-05 | 2023-09-29 | 4735 OLD CANOE CREEK RD, SAINT CLOUD, FL, 347691400, US | 4735 OLD CANOE CREEK RD, SAINT CLOUD, FL, 347691400, US | |||||||||||||||||||||||||||
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| Phone | +1 321-257-3960 |
| Fax | 4076047677 |
Authorized person
| Name | TANIA I MARRERO-SANTIAGO |
| Role | CEO |
| Phone | 3212573960 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102316900 |
| State | FL |
| Issuer | CAQH |
| Number | 14356948 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARRERO TANIA IPsyD | Agent | 4735 Old Canoe Creek Rd., SAINT CLOUD, FL, 34769 |
| Name | Role | Address |
|---|---|---|
| MARRERO TANIA IDR | Director | 4735 Old Canoe Creek Rd., ST CLOUD, FL, 34769 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-04 | 4735 Old Canoe Creek Rd., SAINT CLOUD, FL 34769 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-04 | 4735 Old Canoe Creek Rd., SAINT CLOUD, FL 34769 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-04 | MARRERO, TANIA I, PsyD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-04 | 4735 Old Canoe Creek Rd., SAINT CLOUD, FL 34769 | No data |
| REINSTATEMENT | 2021-10-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-02-12 |
| REINSTATEMENT | 2021-10-01 |
| ANNUAL REPORT | 2020-01-17 |
| Florida Limited Liability | 2019-10-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
