| Entity Name: | FUSION MIND & BODY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Jan 2023 (2 years ago) |
| Document Number: | L23000043286 |
| FEI/EIN Number | 92-2062890 |
| Address: | 1880 NW 36TH ST, OAKLAND PARK, FL 33309 |
| Mail Address: | 1880 NW 36TH ST, OAKLAND PARK, FL 33309 |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891568416 | 2023-11-06 | 2023-11-06 | 1500 NW 62ND ST STE 303, FORT LAUDERDALE, FL, 333091850, US | 1500 NW 62ND ST STE 303, FORT LAUDERDALE, FL, 333091850, US | |||||||||||||
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| Phone | +1 954-951-2242 |
Authorized person
| Name | ERIKA REGIS |
| Role | OWNER |
| Phone | 9549512242 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BARSHOP, WILLIAM | Agent | 1880 NW 36TH ST, OAKLAND PARK, FL 33309 |
| Name | Role | Address |
|---|---|---|
| BARSHOP, WILLIAM | Manager | 1880 NW 36TH ST, OAKLAND PARK, FL 33309 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| Florida Limited Liability | 2023-01-23 |
Date of last update: 10 Jan 2025
Sources: Florida Department of State
