| Entity Name: | FAMILY CHIROPRACTIC HEALTH CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 08 Sep 1982 (42 years ago) |
| Document Number: | F98496 |
| FEI/EIN Number | 592132375 |
| Address: | 13070 CORTEZ BLVD., BROOKSVILLE, FL, 34613 |
| Mail Address: | P.O. BOX 845, BROOKSVILLE, FL, 34605 |
| ZIP code: | 34613 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609279124 | 2014-09-29 | 2014-09-29 | 2027 E EDGEWOOD DR, LAKELAND, FL, 338033601, US | 2027 E EDGEWOOD DR, LAKELAND, FL, 338033601, US | |||||||||||||||||||||||||
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| Phone | +1 863-665-9597 |
| Fax | 8636651588 |
Authorized person
| Name | DR. MABBETT KING RECKORD III |
| Role | CHIROPRACTOR/OWNER |
| Phone | 8636659597 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH3509 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 380014800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DAHMER DAVID K | Agent | 13070 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Name | Role | Address |
|---|---|---|
| DAHMER DAVID K | President | 26197 MOUNTAIN LAKE RD., BROOKSVILLE, FL, 34602 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2006-12-06 | No data | No data |
| REINSTATEMENT | 1997-12-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1996-08-23 | No data | No data |
| REINSTATEMENT | 1995-09-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1994-08-26 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J10000286549 | TERMINATED | 1000000149966 | HERNANDO | 2009-12-15 | 2030-02-16 | $ 1,374.16 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, PORT RICHEY SERVICE CENTER, 6709 RIDGE RD STE 300, PORT RICHEY FL346686842 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
