| Entity Name: | GARY K. STOLTZ, D.C., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 31 Jul 1980 (45 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Jun 2020 (5 years ago) |
| Document Number: | 680539 |
| FEI/EIN Number | 59-2035970 |
| Address: | 2105 PREVATT STREET, C/O BRYAN K STOLTZ, EUSTIS, FL 32726 |
| Mail Address: | 2105 PREVATT STREET, C/O BRYAN K STOLTZ, EUSTIS, FL 32726 |
| ZIP code: | 32726 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609153311 | 2011-11-09 | 2011-11-09 | 2105 PREVATT ST, EUSTIS, FL, 327266131, US | 2105 PREVATT ST, EUSTIS, FL, 327266131, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 352-357-7955 |
| Fax | 3523577254 |
Authorized person
| Name | DR. GARY KENT STOLTZ |
| Role | OWNER |
| Phone | 3523577955 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH2081 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RR MEDICARE |
| Number | 350907427 |
| State | FL |
| Issuer | STATE LICENCE ID- WORK COMP |
| Number | CH2081 |
| State | FL |
| Issuer | MEDICAID |
| Number | 380263900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STOLTZ, BRYAN K. | Agent | 2105 PREVATT STREET, EUSTIS, FL 32726 |
| Name | Role | Address |
|---|---|---|
| STOLTZ, BRYAN K. | President | 2105 PREVATT STREET, EUSTIS, FL |
| Name | Role | Address |
|---|---|---|
| Stoltz, Bryan K, Dr. | Secretary | 2105 PREVATT STREET, EUSTIS, FL 32726 |
| Name | Role | Address |
|---|---|---|
| Stoltz, Bryan K, Dr. | Treasurer | 2105 PREVATT STREET, EUSTIS, FL 32726 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000029026 | EUSTIS CHIROPRACTIC | ACTIVE | 2024-02-23 | 2029-12-31 | No data | 2105 PREVATT ST, EUSTIS, FL, 32726 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2020-06-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-01-15 | 2105 PREVATT STREET, C/O BRYAN K STOLTZ, EUSTIS, FL 32726 | No data |
| CHANGE OF MAILING ADDRESS | 2014-01-15 | 2105 PREVATT STREET, C/O BRYAN K STOLTZ, EUSTIS, FL 32726 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-01-15 | STOLTZ, BRYAN K. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1994-05-01 | 2105 PREVATT STREET, EUSTIS, FL 32726 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-08 |
| ANNUAL REPORT | 2023-03-27 |
| ANNUAL REPORT | 2022-02-28 |
| ANNUAL REPORT | 2021-02-02 |
| REINSTATEMENT | 2020-06-30 |
| ANNUAL REPORT | 2018-01-22 |
| ANNUAL REPORT | 2017-02-06 |
| ANNUAL REPORT | 2016-03-02 |
| ANNUAL REPORT | 2015-01-07 |
| ANNUAL REPORT | 2014-01-15 |
Date of last update: 05 Feb 2025
Sources: Florida Department of State
