| Entity Name: | MINDFUL LOTUS THERAPY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Feb 2022 (3 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 May 2024 (9 months ago) |
| Document Number: | P22000014785 |
| FEI/EIN Number | 88-0805364 |
| Address: | 6990 Griffin Road, Davie, FL, 33314, US |
| Mail Address: | 6990 Griffin Road, Davie, FL, 33314, US |
| ZIP code: | 33314 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871231571 | 2022-05-23 | 2023-01-20 | 6990 GRIFFIN RD, DAVIE, FL, 333144345, US | 6990 GRIFFIN RD, DAVIE, FL, 333144345, US | |||||||||||||||||||||||||
|
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| Phone | +1 754-248-9589 |
| Fax | 7547640054 |
Authorized person
| Name | MRS. LEIGH DANA OJEDA |
| Role | OWNER |
| Phone | 7542489589 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 114413700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OJEDA LEIGH D | Agent | 4418 MORGAN LANE, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| OJEDA LEIGH | President | 4418 MORGAN LANE, DAVIE, FL, 33328 |
| Name | Role | Address |
|---|---|---|
| OJEDA GARETH D | Vice President | 4418 MORGAN LANE, DAVIE, FL, 33328 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-05-01 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-01 | 6990 Griffin Road, Davie, FL 33314 | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 6990 Griffin Road, Davie, FL 33314 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-05-01 | OJEDA, LEIGH D | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-05-01 |
| Domestic Profit | 2022-02-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
