| Entity Name: | MY WELLNESS PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Oct 2022 (2 years ago) |
| Document Number: | L22000429239 |
| FEI/EIN Number | 88-4152813 |
| Address: | 3275 WEST HILLSBORO BLVD, SUITE 206, DEERFIELD BEACH, FL 33442 |
| Mail Address: | 3275 WEST HILLSBORO BLVD, SUITE 206, DEERFIELD BEACH, FL 33442 |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780364067 | 2023-07-20 | 2023-07-20 | 23109 OLD INLET BRIDGE DR, BOCA RATON, FL, 334336825, US | 2900 N UNIVERSITY DR, CORAL SPRINGS, FL, 330655083, US | |||||||||||||
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| Phone | +1 561-846-0367 |
Authorized person
| Name | DIANA PEREZ NUNEZ |
| Role | OWNER/AUTHORIZED OFFICIAL |
| Phone | 5614616255 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEREZ-NUNEZ, DIANA | Agent | 3275 WEST HILLSBORO BLVD, SUITE 206, DEERFIELD BEACH, FL 33442 |
| Name | Role | Address |
|---|---|---|
| PEREZ-NUNEZ, DIANA | Authorized Member | 3275 WEST HILLSBORO BLVD, SUITE 206 DEERFIELD BEACH, FL 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-04 | 3275 WEST HILLSBORO BLVD, SUITE 206, DEERFIELD BEACH, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-04 | 3275 WEST HILLSBORO BLVD, SUITE 206, DEERFIELD BEACH, FL 33442 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-04 | 3275 WEST HILLSBORO BLVD, SUITE 206, DEERFIELD BEACH, FL 33442 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-13 |
| Florida Limited Liability | 2022-10-04 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
