| Entity Name: | MINDZEN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Jan 2023 (2 years ago) |
| Document Number: | L23000054044 |
| FEI/EIN Number | 92-2169025 |
| Address: | 322 W. Bearss Ave, Tampa, FL, 33613, US |
| Mail Address: | 21814 WAVERLY SHORES LN, LAND O LAKES, FL, 34637, US |
| ZIP code: | 33613 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306690722 | 2024-04-12 | 2024-10-02 | 21814 WAVERLY SHORES LN, LAND O LAKES, FL, 346377562, US | 322 W BEARSS AVE, TAMPA, FL, 336131228, US | |||||||||||||||||||||
|
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| Phone | +1 813-575-0477 |
Authorized person
| Name | MR. JOSEPH P BRABHAM JR. |
| Role | MANAGER/PROIVDER |
| Phone | 8135750477 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRABHAM JOSEPH PJR. | Agent | 21814 WAVERLY SHORES LN, LAND O LAKES, FL, 34637 |
| Name | Role | Address |
|---|---|---|
| BRABHAM JOSEPH PJR | Manager | 21814 WAVERLY SHORES LN, LAND O LAKES, FL, 34637 |
| BRABHAM DARA | Manager | 21814 WAVERLY SHORES LN, LAND O LAKES, FL, 34637 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-05 | 322 W. Bearss Ave, Tampa, FL 33613 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| Florida Limited Liability | 2023-01-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
