| Entity Name: | NORTH PALM BEACH MEDICAL WELLNESS CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Aug 2006 (18 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 22 Jan 2013 (12 years ago) |
| Document Number: | L06000084604 |
| FEI/EIN Number | 205445615 |
| Address: | 400 EXECUTIVE CENTER DRIVE, SUITE 105, WEST PALM BEACH, FL, 33401 |
| Mail Address: | 400 EXECUTIVE CENTER DRIVE, SUITE 105, WEST PALM BEACH, FL, 33401 |
| ZIP code: | 33401 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336247634 | 2006-09-20 | 2008-06-17 | 11911 US HIGHWAY 1, SUITE 102, NORTH PALM BEACH, FL, 334082827, US | 11911 US HIGHWAY 1, SUITE 102, NORTH PALM BEACH, FL, 334082827, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 561-626-5433 |
| Fax | 5616263371 |
Authorized person
| Name | DR. RICHARD G. FENN |
| Role | OWNER |
| Phone | 5616265433 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH5263 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS GROUP |
| Number | 76037 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FENN RICHARD | Agent | 400 EXECUTIVE CENTER DRIVE, WEST PALM BEACH, FL, 33401 |
| Name | Role | Address |
|---|---|---|
| FENN RICHARD | Managing Member | 400 EXECUTIVE CENTER DRIVE, SUITE 105, WEST PALM BEACH, FL, 33401 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08021900317 | SPINAL CARE CENTER | EXPIRED | 2008-01-21 | 2013-12-31 | No data | 11911 U.S. HIGHWAY ONE, SUITE 102, NORTH PALM BEACH, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2013-01-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-14 | 400 EXECUTIVE CENTER DRIVE, SUITE 105, WEST PALM BEACH, FL 33401 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-14 | 400 EXECUTIVE CENTER DRIVE, SUITE 105, WEST PALM BEACH, FL 33401 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-14 | 400 EXECUTIVE CENTER DRIVE, SUITE 105, WEST PALM BEACH, FL 33401 | No data |
| REGISTERED AGENT NAME CHANGED | 2009-03-30 | FENN, RICHARD | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2023-04-03 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-05-06 |
| ANNUAL REPORT | 2019-03-29 |
| ANNUAL REPORT | 2018-03-07 |
| ANNUAL REPORT | 2017-04-07 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-01-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
