| Entity Name: | BOYNTON MENTAL HEALTH LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Sep 2021 (3 years ago) |
| Document Number: | L21000396645 |
| FEI/EIN Number | 87-2600118 |
| Address: | 11571 PONYWALK TRL, BOYNTON BEACH, FL, 33473, US |
| Mail Address: | 12361 Hagen Ranch Rd, Suite 503 PMB 1011, BOYNTON BEACH, FL, 33437, US |
| ZIP code: | 33473 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760196109 | 2023-01-10 | 2023-01-10 | 12765 FOREST HILL BLVD STE 1309, WELLINGTON, FL, 334144781, US | 12765 FOREST HILL BLVD STE 1309, WELLINGTON, FL, 334144781, US | |||||||||||||
|
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| Phone | +1 561-395-9279 |
Authorized person
| Name | PETER R BRONSTEIN |
| Role | OWNER |
| Phone | 5613969279 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Peter Bronstein R | Agent | 11571 Ponywalk Trl, Boynton Beach, FL, 33473 |
| Name | Role | Address |
|---|---|---|
| BRONSTEIN PETER R | Authorized Member | 11571 PONYWALK TRL, BOYNTON BEACH, FL, 33473 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000154113 | PETER'S PSYCHIATRY | ACTIVE | 2023-12-18 | 2028-12-31 | No data | 12361 HAGEN RANCH RD, SUITE 503 PMB 1011, BOYNTON BEACH, FL, 33437 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-09-28 | 11571 PONYWALK TRL, BOYNTON BEACH, FL 33473 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-21 | Peter , Bronstein Robert | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-03-21 | 11571 Ponywalk Trl, Boynton Beach, FL 33473 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-04-23 |
| Florida Limited Liability | 2021-09-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
