| Name: | MINDBLOOM PROVIDER GROUP, P.A. |
| Jurisdiction: | New York |
| Legal type: | FOREIGN PROFESSIONAL SERVICE CORPORATION |
| Status: | Active |
| Date of registration: | 10 Nov 2020 (4 years ago) |
| Entity Number: | 5875068 |
| County: | New York |
| Place of Formation: | Florida |
| Address: | 7901 4th St N STE 300, St. Petersburg, FL, United States, 33702 |
| Address ZIP Code: | 33702 |
| Principal Address: | 1317 Edgewater Dr. #1583, Orlando, FL, United States, 32804 |
| Principal Address ZIP Code: | 32804 |
| Name | Role | Address |
|---|---|---|
| MINDBLOOM PROVIDER GROUP, P.A. | DOS Process Agent | 7901 4th St N STE 300, St. Petersburg, FL, United States, 33702 |
| Name | Role | Address |
|---|---|---|
| LEONARDO VANDO | Chief Executive Officer | 1317 EDGEWATER DR. #1583, ORLANDO, FL, United States, 32804 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2024-11-03 | 2024-11-03 | Address | 1317 EDGEWATER DR. #1583, ORLANDO, FL, 32804, USA (Type of address: Chief Executive Officer) |
| 2020-11-10 | 2024-11-03 | Address | 54 ALLEN ST STE 7B, NEW YORK, NY, 10002, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 241103000636 | 2024-11-03 | BIENNIAL STATEMENT | 2024-11-03 |
| 230118004215 | 2023-01-18 | BIENNIAL STATEMENT | 2022-11-01 |
| 201110000031 | 2020-11-10 | APPLICATION OF AUTHORITY | 2020-11-10 |
Date of last update: 03 Nov 2024
Sources: New York Secretary of State
