| Entity Name: | NEUROPLACE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Jan 2014 (11 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | P14000005066 |
| Address: | 6290 BETTY AVENUE, COCOA, FL, 32927 |
| Mail Address: | 6290 BETTY AVENUE, COCOA, FL, 32927 |
| ZIP code: | 32927 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396163952 | 2014-04-01 | 2014-04-01 | 6290 BETTY AVE, COCOA, FL, 329274202, US | 6290 BETTY AVE, COCOA, FL, 329274202, US | |||||||||||||||||||||||||
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| Phone | +1 321-301-4299 |
| Fax | 3213014299 |
Authorized person
| Name | DR. VESNA MICIC |
| Role | PRESIDENT |
| Phone | 8323703789 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | ME104201 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002469900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MICIC VESNA M.D. | Director | 6290 BETTY AVENUE, COCOA, FL, 32927 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2015-11-30 |
| Domestic Profit | 2014-01-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
