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OVERLEA-FULLERTON CHIROPRACTIC CENTER, P.C. - Florida Company Profile

Company Details

Entity Name: OVERLEA-FULLERTON CHIROPRACTIC CENTER, P.C.
Jurisdiction: FLORIDA
Filing Type: Foreign Profit
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 30 Aug 2004 (21 years ago)
Document Number: F04000005048
FEI/EIN Number 521907464

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: C/O DR. BRIAN AUGUSTINE, 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL, 33543, US
Mail Address: C/O DR. BRIAN AUGUSTINE, 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL, 33543, US
ZIP code: 33543
County: Pasco
Place of Formation: MARYLAND

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780801761 2007-04-19 2010-10-20 5317 VILLAGE MARKET DRIVE, WESLEY CHAPEL, FL, 33544, US 5317 VILLAGE MARKET DRIVE, WESLEY CHAPEL, FL, 33544, US

Contacts

Phone +1 813-994-6008
Fax 8139943063

Authorized person

Name BRIAN J AUGUSTINE
Role CHIROPRACTIC PHYSICIAN
Phone 8139946008

Taxonomy

Taxonomy Code 111N00000X - Chiropractor
License Number CH006174
State FL
Is Primary Yes

Other Provider Identifiers

Issuer WELLCARE PRVD#
Number 271773
State FL
Issuer BCBS PRVD#
Number 89273
State FL
Issuer AVMED PRVD#
Number 295986
State FL
Issuer CHIRO ALLIANCE #
Number 593466707
State FL
Issuer STATE LICENSE #
Number CH006174
State FL
Issuer MEDICAID
Number 381806300
State FL

Key Officers & Management

Name Role Address
AUGUSTINE BRIAN JDr. President 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL, 33543
AUGUSTINE BRIAN JDr. Secretary 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL, 33543
AUGUSTINE BRIAN JDr. Treasurer 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL, 33543
AUGUSTINE BRIAN JDr. Director 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL, 33543
BEARD ROBERT GJr. Director 3432 HAWKS HILL TRL, TALLAHASSEE, FL, 32312
BEARD ROBERT GJr. Agent 3432 HAWKS HILL TRL, TALLAHASSEE, FL, 32312

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000064230 AUGUSTINE CHIROPRACTIC ACTIVE 2013-06-25 2028-12-31 - 3432 HAWKS HILL TRAIL, TALLAHASSEE, FL, 32312

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-01-15 3432 HAWKS HILL TRL, TALLAHASSEE, FL 32312 -
REGISTERED AGENT NAME CHANGED 2013-04-08 BEARD, ROBERT G, Jr. -
CHANGE OF PRINCIPAL ADDRESS 2010-02-20 C/O DR. BRIAN AUGUSTINE, 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL 33543 -
CHANGE OF MAILING ADDRESS 2010-02-20 C/O DR. BRIAN AUGUSTINE, 5317 VILLAGE MARKET DR, WESLEY CHAPEL, FL 33543 -

Documents

Name Date
ANNUAL REPORT 2024-02-01
ANNUAL REPORT 2023-03-04
ANNUAL REPORT 2022-03-01
ANNUAL REPORT 2021-01-15
ANNUAL REPORT 2020-01-24
ANNUAL REPORT 2019-02-16
ANNUAL REPORT 2018-02-02
ANNUAL REPORT 2017-02-24
ANNUAL REPORT 2016-02-18
ANNUAL REPORT 2015-01-31

Date of last update: 03 Mar 2025

Sources: Florida Department of State