| Entity Name: | MICHAEL J. PETTELLA, DC, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Dec 2006 (18 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L06000121486 |
| FEI/EIN Number | 208106324 |
| Address: | 6175 SE 126TH LANE, BELLEVIEW, FL, 34420, US |
| Mail Address: | 6175 SE 126TH LANE, BELLEVIEW, FL, 34420, US |
| ZIP code: | 34420 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891013900 | 2010-05-13 | 2010-05-13 | 6175 SE 126TH LN, BELLEVIEW, FL, 344205208, US | 6175 SE 126TH LN, BELLEVIEW, FL, 344205208, US | |||||||||||||||||||||||
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| Phone | +1 352-245-8300 |
Authorized person
| Name | MICHAEL PETTELLA |
| Role | PRESIDENT |
| Phone | 3522458300 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH0006496 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | 350052194 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PETTELLA MICHAEL J | Agent | 6175 SE 126TH LANE, BELLEVIEW, FL, 34420 |
| Name | Role | Address |
|---|---|---|
| PETTELLA MICHAEL J | Managing Member | 6175 SE 126TH LANE, BELLEVIEW, FL, 34420 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-08 | 6175 SE 126TH LANE, BELLEVIEW, FL 34420 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-08 | 6175 SE 126TH LANE, BELLEVIEW, FL 34420 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-01-08 | 6175 SE 126TH LANE, BELLEVIEW, FL 34420 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-01-15 |
| ANNUAL REPORT | 2012-01-20 |
| ANNUAL REPORT | 2011-01-08 |
| ANNUAL REPORT | 2010-01-10 |
| ANNUAL REPORT | 2009-02-16 |
| ANNUAL REPORT | 2008-01-24 |
| Florida Limited Liability | 2006-12-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
