| Entity Name: | GREAT MIND PSYCHIATRY PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 09 May 2024 (9 months ago) |
| Document Number: | L24000216728 |
| Address: | 9101 LAKERIDGE BLVD, SUITE 22, BOCA RATON, FL 33496 |
| Mail Address: | 9101 LAKERIDGE BLVD, SUITE 22, BOCA RATON, FL 33496 |
| ZIP code: | 33496 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255171187 | 2024-05-29 | 2024-07-02 | 9101 LAKERIDGE BLVD STE 22, BOCA RATON, FL, 334962180, US | 9101 LAKERIDGE BLVD STE 22, BOCA RATON, FL, 334962180, US | |||||||||||||
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| Phone | +1 561-920-0052 |
Authorized person
| Name | MELANA RABINOVICH |
| Role | OWNER |
| Phone | 5619200052 |
Taxonomy
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RABINOVICH, MELANA | Agent | 9101 LAKERIDGE BLVD., SUITE 22, BOCA RATON, FL 33496 |
| Name | Role | Address |
|---|---|---|
| RABINOVICH, MELANA, OWNER | Authorized Representative | 9101 LAKERIDGE BLVD. SUITE 22, BOCA RATON, FL 33496 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-05-09 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
