| Entity Name: | BREVARD PSYCHIATRY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Mar 2021 (4 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 May 2021 (4 years ago) |
| Document Number: | L21000137044 |
| FEI/EIN Number | 86-3081161 |
| Address: | 759 GLENGARRY DR, MELBOURNE, FL, 32940, US |
| Mail Address: | 759 GLENGARRY DR, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669101861 | 2022-06-06 | 2022-06-06 | 6300 N WICKHAM RD, STE 130 #156, MELBOURNE, FL, 329402029, US | 101 E FLORIDA AVE, MELBOURNE, FL, 32901, US | |||||||||||||||
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| Phone | +1 801-609-8388 |
| Fax | 8017970245 |
Authorized person
| Name | JOSEPH HON-FU SIN |
| Role | PRESIDENT/100 PERCENT OWNER |
| Phone | 4352876833 |
Taxonomy
| Taxonomy Code | 2084P0802X - Addiction Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SIN JOSEPH | Agent | 759 GLENGARRY DR, MELBOURNE, FL, 32940 |
| Name | Role | Address |
|---|---|---|
| SIN JOSEPH | Manager | 759 GLENGARRY DR, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2021-05-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-05-03 | SIN, JOSEPH | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-05-03 | 759 GLENGARRY DR, MELBOURNE, FL 32940 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-08 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-03 |
| LC Amendment | 2021-05-03 |
| Florida Limited Liability | 2021-03-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
