| Entity Name: | ENVIZION THERAPEUTIC SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Mar 2021 (4 years ago) |
| Document Number: | L21000112132 |
| FEI/EIN Number | 86-2744579 |
| Address: | 2475 Palm Bay Road, Suite 145 25, PALM BAY, FLORIDA, FL, 32905, US |
| Mail Address: | 2475 Palm Bay Road, Suite 145 25, PALM BAY, FLORIDA, FL, 32905, US |
| ZIP code: | 32905 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649941725 | 2021-09-28 | 2021-09-28 | 4651 BABCOCK ST NE STE 18, PALM BAY, FL, 329052808, US | 20535 NW 2ND AVE STE 204, MIAMI, FL, 331692547, US | |||||||||||||
|
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| Phone | +1 321-344-4901 |
Authorized person
| Name | TAMARA HARRIS |
| Role | LCSW |
| Phone | 3213444901 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HARRIS TAMARA D | Agent | 2475 Palm Bay Road, PALM BAY, FL, 32905 |
| Name | Role | Address |
|---|---|---|
| HARRIS TAMARA D | Manager | 2475 Palm Bay Road, PALM BAY, FL, 32905 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-16 | 2475 Palm Bay Road, Suite 145 25, PALM BAY, FLORIDA, FL 32905 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-16 | 2475 Palm Bay Road, Suite 145 25, PALM BAY, FLORIDA, FL 32905 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-16 | 2475 Palm Bay Road, Suite 145 25, PALM BAY, FL 32905 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-11 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-25 |
| Florida Limited Liability | 2021-03-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
