| Entity Name: | NEURCOG MIAMI CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Jan 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Dec 2022 (2 years ago) |
| Document Number: | P17000000333 |
| FEI/EIN Number | 81-4862893 |
| Address: | 1330 SW 22ND ST - STE. 209, MIAMI, FL, 33145 |
| Mail Address: | 1330 SW 22ND ST - STE. 209, MIAMI, FL, 33145 |
| ZIP code: | 33145 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578000477 | 2017-01-30 | 2022-03-23 | 1330 SW 22ND ST STE 209, MIAMI, FL, 331452933, US | 1330 SW 22ND ST STE 209, MIAMI, FL, 331452933, US | |||||||||||||||||||||||||
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| Phone | +1 786-483-8381 |
| Fax | 3055035405 |
Authorized person
| Name | CARLOS ANDRES CASTILLO |
| Role | PRESIDENT/OWNER |
| Phone | 7864838381 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | ARNP9350825 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 020979600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CASTILLO CARLOS ANDRES | Agent | 1330 SW 22ND ST - STE. 209, MIAMI, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| CASTILLO CARLOS ANDRES | President | 1330 SW 22 ST, MIAMI, FL, 33145 |
| Name | Role | Address |
|---|---|---|
| CASTILLO CARLOS ANDRES | Director | 1330 SW 22 ST, MIAMI, FL, 33145 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-12-09 | CASTILLO, CARLOS ANDRES | No data |
| REINSTATEMENT | 2022-12-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-11-09 | 1330 SW 22ND ST - STE. 209, MIAMI, FL 33145 | No data |
| AMENDMENT | 2021-11-09 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-11-09 | 1330 SW 22ND ST - STE. 209, MIAMI, FL 33145 | No data |
| CHANGE OF MAILING ADDRESS | 2021-11-09 | 1330 SW 22ND ST - STE. 209, MIAMI, FL 33145 | No data |
| AMENDMENT | 2020-01-21 | No data | No data |
| AMENDMENT | 2018-05-22 | No data | No data |
| AMENDMENT | 2017-02-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-01-20 |
| REINSTATEMENT | 2022-12-09 |
| Amendment | 2021-11-09 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-04-04 |
| Amendment | 2020-01-21 |
| ANNUAL REPORT | 2019-03-15 |
| Amendment | 2018-05-22 |
| ANNUAL REPORT | 2018-01-30 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
