| Entity Name: | SOUTH FLORIDA MENTAL HEALTH GROUP, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 31 Oct 2022 (2 years ago) |
| Document Number: | L22000466638 |
| FEI/EIN Number | 92-2751279 |
| Address: | 8765 NW 110TH STREET, HIALEAH GARDENS, FL 33018 |
| Mail Address: | 8765 NW 110TH STREET, HIALEAH GARDENS, FL 33018 |
| ZIP code: | 33018 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588357834 | 2023-06-01 | 2023-06-01 | 8765 NW 110TH ST, HIALEAH GARDENS, FL, 330184510, US | 8765 NW 110TH ST, HIALEAH GARDENS, FL, 330184510, US | |||||||||||||
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| Phone | +1 786-389-2691 |
Authorized person
| Name | MANUEL RIVERO JR. |
| Role | APRN, PMHNP-BC |
| Phone | 7863892691 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RIVERO, MANUEL, JR. | Agent | 8765 NW 110TH STREET, HIALEAH GARDENS, FL 33018 |
| Name | Role | Address |
|---|---|---|
| RIVERO, MANUEL, JR. | Manager | 8765 NW 110TH STREET, HIALEAH GARDENS, FL 33018 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-07 | 8765 NW 110TH STREET, HIALEAH GARDENS, FL 33018 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-07 | 8765 NW 110TH STREET, HIALEAH GARDENS, FL 33018 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-08 |
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-03-07 |
| Florida Limited Liability | 2022-10-31 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
