| Entity Name: | JACK HAZAN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 Aug 2022 (2 years ago) |
| Document Number: | L22000350404 |
| FEI/EIN Number | 85-3538406 |
| Address: | 1508 BAY RD, APT. 114, MIAMI BEACH, FL 33139 |
| Mail Address: | 1508 BAY RD, APT. 114, MIAMI BEACH, FL 33139 |
| ZIP code: | 33139 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508639279 | 2023-11-03 | 2024-01-05 | 401 W 25TH ST APT 13C, NEW YORK, NY, 100016575, US | 1504 BAY RD APT 2003, MIAMI BEACH, FL, 331393277, US | |||||||||||||||
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| Phone | +1 917-453-9306 |
| Phone | +1 646-692-0761 |
Authorized person
| Name | JACK HAZAN |
| Role | OWNER |
| Phone | 9174539306 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| O'CONNOR & RODRIGUEZ, PA | Agent | 660 NE 95TH ST, SUITE 7, MIAMI SHORES, FL 33138 |
| Name | Role | Address |
|---|---|---|
| HAZAN, JACK | Manager | 1508 BAY RD APT. 114, MIAMI BEACH, FL 33139 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000068640 | MODERN THERAPY GROUP | COUNSELING AND THERAPY MIAMI | ACTIVE | 2024-05-31 | 2029-12-31 | No data | 1504 BAY RD APT 2003, MIAMI BEACH, FL, 33139 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-08 |
| ANNUAL REPORT | 2023-03-01 |
| Florida Limited Liability | 2022-08-09 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
