| Entity Name: | GOMEZ BEHAVIORAL SOLUTION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Jan 2022 (3 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Nov 2024 (4 months ago) |
| Document Number: | L22000027421 |
| FEI/EIN Number | 87-4647778 |
| Address: | 1150 NW 72 AVE, SUITE 350, MIAMI, FL 33126 |
| Mail Address: | 1150 NW 72 AVE, SUITE 350, MIAMI, FL 33126 |
| ZIP code: | 33126 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285400515 | 2023-11-28 | 2024-05-31 | 1150 NW 72ND AVE STE 540, MIAMI, FL, 331261947, US | 1150 NW 72ND AVE STE 540, MIAMI, FL, 331261947, US | |||||||||||||||||||||||
|
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| Phone | +1 862-287-8017 |
| Fax | 7865338000 |
Authorized person
| Name | MAILYN HERNANDEZ |
| Role | OWNER/ OFFICER |
| Phone | 7862287801 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ GOMEZ, MAILYN | Agent | 15113 SW 35 TER, MIAMI, FL 33185 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ GOMEZ, MAILYN | Manager | 15113 SW 35 TERRA, MIAMI, FL 33185 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-11-05 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-05 | 1150 NW 72 AVE, SUITE 350, MIAMI, FL 33126 | No data |
| CHANGE OF MAILING ADDRESS | 2024-11-05 | 1150 NW 72 AVE, SUITE 350, MIAMI, FL 33126 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-24 | 15113 SW 35 TER, MIAMI, FL 33185 | No data |
| LC AMENDMENT | 2023-11-07 | No data | No data |
| Name | Date |
|---|---|
| LC Amendment | 2024-11-05 |
| ANNUAL REPORT | 2024-01-24 |
| LC Amendment | 2023-11-07 |
| ANNUAL REPORT | 2023-04-19 |
| Florida Limited Liability | 2022-01-25 |
Date of last update: 12 Feb 2025
Sources: Florida Department of State
