| Entity Name: | MINDFUL PSYCHOLOGY AND WELLNESS CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Oct 2019 (5 years ago) |
| Document Number: | P19000077268 |
| FEI/EIN Number | 84-4210395 |
| Address: | 964 SW 101 WAY, PEMBROKE PINES, FL, 33025, US |
| Mail Address: | 964 SW 101 WAY, PEMBROKE PINES, FL, 33025, US |
| ZIP code: | 33025 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437822988 | 2021-07-30 | 2021-07-30 | 1931 NW 150TH AVE STE 116, PEMBROKE PINES, FL, 330282873, US | 1931 NW 150TH AVE STE 116, PEMBROKE PINES, FL, 330282873, US | |||||||||||||||||
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| Phone | +1 786-383-1856 |
| Fax | 4314872786 |
| Fax | 7864314872 |
Authorized person
| Name | DR. LISA DAVENPORT |
| Role | PRESIDENT |
| Phone | 7863831856 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAVENPORT LISA | Agent | 964 SW 101 WAY, PEMBROKE PINES, FL, 33025 |
| Name | Role | Address |
|---|---|---|
| DAVENPORT LISA | President | 964 SW 101 WAY, PEMBROKE PINES, FL, 33025 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-03-13 |
| ANNUAL REPORT | 2021-02-06 |
| ANNUAL REPORT | 2020-02-09 |
| Domestic Profit | 2019-10-02 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
