| Entity Name: | KETAMINE CLINIC SOUTH FLORIDA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Nov 2019 (5 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 28 Feb 2020 (5 years ago) |
| Document Number: | L19000291077 |
| FEI/EIN Number | 84-4293158 |
| Address: | 41 N Federal Hwy, pompano beach, FL, 33062, US |
| Mail Address: | 41 N Federal Hwy, 2nd floor, Pompano Beach, FL, 33062, US |
| ZIP code: | 33062 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942988613 | 2023-07-11 | 2023-07-11 | 41 N FEDERAL HWY STE A, POMPANO BEACH, FL, 330624304, US | 41 N FEDERAL HWY STE A, POMPANO BEACH, FL, 330624304, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 954-320-4944 |
| Fax | 9544005805 |
Authorized person
| Name | KHALIUN CHULUUN REED |
| Role | PARTNER |
| Phone | 3053317149 |
Taxonomy
| Taxonomy Code | 261QI0500X - Infusion Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Taxonomy Code | 364SP0809X - Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| Is Primary | No |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REED KHALIUN | Agent | 1827 Sandpiper Point Pl, DEERFIELD BEACH, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Reed Khaliun C | Authorized Person | 1827 Sandpiper Point Pl, DEERFIELD BEACH, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| Reed Khaliun C | Manager | 1827 Sandpiper Point Pl, DEERFIELD BEACH, FL, 33442 |
| COTTO SONIA | Manager | 1624 NW 2ND AVE, FT LAUDERDALE, FL, 33311 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-26 | 1827 Sandpiper Point Pl, DEERFIELD BEACH, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2021-01-09 | 41 N Federal Hwy, unit a, pompano beach, FL 33062 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-03-10 | 41 N Federal Hwy, unit a, pompano beach, FL 33062 | No data |
| LC AMENDMENT | 2020-02-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-28 | REED, KHALIUN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-26 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-01-11 |
| ANNUAL REPORT | 2021-01-09 |
| LC Amendment | 2020-02-28 |
| Florida Limited Liability | 2019-11-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
