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TRAUMATIC BRAIN DIAGNOSTIC LLC - Florida Company Profile

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Company Details

Entity Name: TRAUMATIC BRAIN DIAGNOSTIC LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 25 Oct 2019 (6 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 15 Dec 2020 (5 years ago)
Document Number: L19000268200
FEI/EIN Number 84-3474201
Address: 1324 Seven Springs Blvd, #159, Trinity, FL, 34655, US
Mail Address: 1324 SEVEN SPRINGS BLVD #159, TRINITY, FL, 34655, US
ZIP code: 34655
City: New Port Richey
County: Pasco
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Leonard Edward Chief Operating Officer 1501 Doyle Carlton Dr Unit 410, Tampa, FL, 33602
BLACKBURN CHARLES Agent 1324 Seven Springs Blvd, 159, Trinity, FL, 34655
BLACKBURN CHARLES Manager 1324 Seven Springs Blvd, 159, Trinity, FL, 34655

National Provider Identifier

NPI Number:
1003431396
Certification Date:
2020-06-11

Authorized Person:

Name:
MS. CAROLINE ADAMS
Role:
ACCOUNT ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
2084P0301X - Brain Injury Medicine (Psychiatry & Neurology) Physician
Is Primary:
Yes

Contacts:

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000064025 TRAUMATIC BRAIN DIAGNOSTICS LLC ACTIVE 2020-06-08 2025-12-31 - 1814 WELLNESS LANE, TRINITY, FL, 34655

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-01-19 1324 Seven Springs Blvd, #159, Trinity, FL 34655 -
REGISTERED AGENT ADDRESS CHANGED 2022-04-14 1324 Seven Springs Blvd, 159, Trinity, FL 34655 -
LC DISSOCIATION MEM 2020-12-15 - -
LC STMNT OF RA/RO CHG 2020-12-15 - -
CHANGE OF MAILING ADDRESS 2020-12-10 1324 Seven Springs Blvd, #159, Trinity, FL 34655 -

Documents

Name Date
ANNUAL REPORT 2025-01-28
ANNUAL REPORT 2024-01-19
ANNUAL REPORT 2023-02-21
ANNUAL REPORT 2022-04-14
ANNUAL REPORT 2021-03-10
CORLCDSMEM 2020-12-15
CORLCRACHG 2020-12-15
ANNUAL REPORT 2020-06-16
Florida Limited Liability 2019-10-25

USAspending Awards / Financial Assistance

Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
11725.00
Total Face Value Of Loan:
11725.00

Paycheck Protection Program

Jobs Reported:
2
Initial Approval Amount:
$11,725
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$11,725
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$11,818.47
Servicing Lender:
Valley National Bank
Use of Proceeds:
Payroll: $11,725

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Date of last update: 01 Aug 2025

Sources: Florida Department of State