| Entity Name: | SHUTT CHIROPRACTIC CENTER, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Jul 2004 (21 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 31 Aug 2004 (20 years ago) |
| Document Number: | L04000050126 |
| FEI/EIN Number | 562468468 |
| Address: | 1221 E TARPON AVENUE, TARPON SPRINGS, FL, 34689, US |
| Mail Address: | 1221 E TARPON AVENUE, TARPON SPRINGS, FL, 34689, US |
| ZIP code: | 34689 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033200225 | 2006-09-27 | 2014-05-05 | 1221 E TARPON AVE, TARPON SPRINGS, FL, 346895441, US | 1221 E TARPON AVE, TARPON SPRINGS, FL, 346895441, US | |||||||||||||||||||||||||||||||
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| Phone | +1 727-771-8181 |
| Fax | 7279408997 |
Authorized person
| Name | DR. MICHELE L SHUTT |
| Role | OWNER/PHYSICIAN |
| Phone | 7277718181 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH7471 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381304500 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | K6328 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Shutt Michele L | Agent | 1221 E Tarpon Ave, Tarpon Springs, FL, 34689 |
| Name | Role | Address |
|---|---|---|
| SHUTT MICHELE L | Manager | 1221 E. Tarpon Ave, Tarpon Springs, FL, 34689 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-04-30 | Shutt, Michele L | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-30 | 1221 E Tarpon Ave, Michele L Shutt, Tarpon Springs, FL 34689 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-10 | 1221 E TARPON AVENUE, TARPON SPRINGS, FL 34689 | No data |
| AMENDMENT | 2004-08-31 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-26 |
| ANNUAL REPORT | 2022-03-25 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-03-30 |
| ANNUAL REPORT | 2019-04-09 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-02-06 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-03-18 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
