| Entity Name: | MENTALYZE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 18 Oct 2024 (4 months ago) |
| Document Number: | L24000445939 |
| Address: | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 |
| Mail Address: | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 |
| ZIP code: | 33702 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982427175 | 2024-11-05 | 2024-11-08 | 7901 4TH ST N # 24297, ST PETERSBURG, FL, 337024305, US | 6470 WAY POINT BLVD, HARMONY, FL, 347736160, US | |||||||||||||||||||||||
|
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| Phone | +1 321-334-3742 |
| Fax | 4808646048 |
Authorized person
| Name | MR. ERIC PALMER |
| Role | MANAGER |
| Phone | 3213343742 |
Taxonomy
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | Yes |
| Name | Role |
|---|---|
| NORTHWEST REGISTERED AGENT LLC | Agent |
| Name | Role | Address |
|---|---|---|
| PALMER, ERIC | Manager | 6470 WAY POINT BLVD, SAINT CLOUD, FL 34773 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000137973 | MENTALYZE | ACTIVE | 2024-11-12 | 2029-12-31 | No data | 7901 4TH ST N STE 300, ST. PETERSBURG, FL, 33702 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-04-01 | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 | No data |
| CHANGE OF MAILING ADDRESS | 2025-04-01 | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | 7901 4TH ST N STE 300, ST. PETERSBURG, FL 33702 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-10-18 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
