| Entity Name: | PALAZZO MENTAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Dec 2020 (4 years ago) |
| Document Number: | L20000368544 |
| FEI/EIN Number | 85-4150805 |
| Address: | 12540 SW 8 STREET, MIAMI, FL 33184 |
| Mail Address: | 12540 SW 8 STREET, MIAMI, FL 33184 |
| ZIP code: | 33184 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063103505 | 2023-05-16 | 2024-11-08 | 12540 SW 8TH ST, MIAMI, FL, 331841412, US | 12540 SW 8TH ST, MIAMI, FL, 331841412, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 305-705-6840 |
| Fax | 7866550185 |
Authorized person
| Name | CHAVELIS MORALES |
| Role | AUTHORIZED OFFICIAL |
| Phone | 3057056840 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 261QH0700X - Hearing and Speech Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QX0100X - Occupational Medicine Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MORALES, CHAVELIS | Agent | 12540 SW 8 STREET, MIAMI, FL 33184 |
| Name | Role | Address |
|---|---|---|
| MORALES, CHAVELIS | Authorized Member | 12540 SW 8 STREET, MIAMI, FL 33184 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000149987 | PALAZZO HEALTH CARE CLINIC | ACTIVE | 2021-11-08 | 2026-12-31 | No data | 12542 SW 8TH ST, MIAMI, FL, 33184 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-10 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-07-30 |
| Florida Limited Liability | 2020-12-03 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
