| Entity Name: | MINDTRAIN PSYCHIATRY AND CONSULTING PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Jul 2022 (3 years ago) |
| Document Number: | L22000327244 |
| FEI/EIN Number | 88-3428813 |
| Address: | 15113 NW 149TH RD, ALACHUA, FL 32615 |
| Mail Address: | 15113 NW 149TH RD, ALACHUA, FL 32615 |
| ZIP code: | 32615 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225880677 | 2024-04-01 | 2024-10-24 | 15113 NW 149TH RD, ALACHUA, FL, 326150253, US | 15113 NW 149TH RD, ALACHUA, FL, 326150253, US | |||||||||||||
|
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| Phone | +1 352-286-1490 |
Authorized person
| Name | DR. KISHAN NALLAPULA |
| Role | OWNER |
| Phone | 3868534835 |
Taxonomy
| Taxonomy Code | 2084P0804X - Child & Adolescent Psychiatry Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NALLAPULA, KISHAN, MD | Agent | 15113 NW 149TH RD, ALACHUA, FL 32615 |
| Name | Role | Address |
|---|---|---|
| NALLAPULA, KISHAN, MD | Manager | 15113 NW 149TH RD, ALACHUA, FL 32615 |
| Name | Role | Address |
|---|---|---|
| NALLAPULA, ROHINI K | Authorized Member | 15113 NW 149TH RD, ALACHUA, FL 32615 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000066208 | GAINESVILLE PSYCHIATRY, TMS AND PSYCHEDELICS | ACTIVE | 2024-05-23 | 2029-12-31 | No data | 13800 TECH CITY CIRCLE STE 320, ALACHUA, FL, 32615 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-19 |
| Florida Limited Liability | 2022-07-25 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
