| Entity Name: | VERO BEACH COGNITIVE CENTER LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Oct 2022 (2 years ago) |
| Document Number: | L22000464296 |
| FEI/EIN Number | 92-0862991 |
| Address: | 333 17TH STREET, SUITE M, VERO BEACH, FL, 32960, US |
| Mail Address: | 333 17TH STREET, SUITE M, VERO BEACH, FL, 32960, US |
| ZIP code: | 32960 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023791738 | 2023-08-09 | 2023-08-09 | 333 17TH ST STE M, VERO BEACH, FL, 329605686, US | 333 17TH ST STE M, VERO BEACH, FL, 329605686, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 772-584-3083 |
| Fax | 7722183003 |
Authorized person
| Name | DR. THERESA A PRESCOTT |
| Role | MEDICAL DIRECTOR |
| Phone | 7725843083 |
Taxonomy
| Taxonomy Code | 2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician |
| Is Primary | No |
| Taxonomy Code | 2084D0003X - Diagnostic Neuroimaging (Psychiatry & Neurology) Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0301X - Brain Injury Medicine (Psychiatry & Neurology) Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 2084P0802X - Addiction Psychiatry Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| Regan Brion MGR | Agent | 333 17TH STREET, VERO BEACH, FL, 32960 |
| Name | Role | Address |
|---|---|---|
| VELIS KOSTA | Manager | 333 17TH STREET, SUITE M, VERO BEACH, FL, 32960 |
| PRESCOTT DR. THERESA | Manager | 333 17TH STREET, SUITE U, VERO BEACH, 32960 |
| Regan Brion J | Manager | 333 17th St Ste M, Vero Beach, FL, 32960 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-09 | Regan, Brion, MGR | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-03-01 |
| Florida Limited Liability | 2022-10-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
