| Entity Name: | CHIROPRACTIC LIFE CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 14 Nov 2006 (18 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | L06000110346 |
| FEI/EIN Number | 20-5885235 |
| Address: | 400 BARTON BLVD., SUITE 201, ROCKLEDGE, FL 32955 |
| Mail Address: | 400 BARTON BLVD., SYUTE 201, ROCKLEDGE, FL 32955 |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073773388 | 2008-06-10 | 2008-06-10 | 400 BARTON BLVD, SUITE 201, ROCKLEDGE, FL, 329552706, US | 400 BARTON BLVD, SUITE 201, ROCKLEDGE, FL, 329552706, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 321-633-1400 |
| Fax | 3216377057 |
Authorized person
| Name | DR. MICHAEL CLAY BISHOP |
| Role | OWNER |
| Phone | 3216331400 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH7721 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 55880 |
| State | FL |
| Issuer | PTAN |
| Number | 5954350001 |
| Name | Role | Address |
|---|---|---|
| BISHOP, MICHAEL C | Agent | 400 BARTON BLVD., #201, ROCKLEDGE, FL 32955 |
| Name | Role | Address |
|---|---|---|
| BISHOP, MICHAEL | D.C. | 400 BARTON BLVD., #201, ROCKLEDGE, FL 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| CANCEL ADM DISS/REV | 2007-10-08 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-10-08 | 400 BARTON BLVD., SUITE 201, ROCKLEDGE, FL 32955 | No data |
| CHANGE OF MAILING ADDRESS | 2007-10-08 | 400 BARTON BLVD., SUITE 201, ROCKLEDGE, FL 32955 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-10-08 | BISHOP, MICHAEL C | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J14000228386 | LAPSED | 11-CC-39813 | BREVARD COUNTY COURT | 2014-01-15 | 2019-02-25 | $1,486.26 | YELLOWBOOK, INC. FKA YELLOW BOOK SALES AND DISTRIBUTION, C/O SPRECHMAN & ASSOCIATES, P.A., 2775 SUNNY ISLES BLVD 100, NORTH MIAMI BEACH, FL 33160 |
| J12000041536 | TERMINATED | 05-2011-CC-42302-XXXX-XX | CTY. CT. BREVARD CTY. FL | 2011-12-07 | 2017-01-23 | $9,552.46 | TIMEPAYMENT CORP., 16 NEW ENGLAND EXECUTIVE PARK, SUITE 200, BURLINGTON, MA 01803 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2007-10-08 |
| Florida Limited Liability | 2006-11-14 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State
