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  5. ROACH FAMILY CHIROPRACTIC LLC

ROACH FAMILY CHIROPRACTIC LLC

Company Details

Entity Name: ROACH FAMILY CHIROPRACTIC LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 07 Aug 2007 (17 years ago)
Date of dissolution: 25 Sep 2015 (9 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2015 (9 years ago)
Document Number: L07000081361
FEI/EIN Number 260728901
Address: 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701
Mail Address: PO BOX 947809, MAITLAND, FL, 32794
ZIP code: 32701
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578704458 2009-03-23 2010-12-04 251 N MAITLAND AVE, SUITE 116, ALTAMONTE SPRINGS, FL, 327014914, US 251 N MAITLAND AVE, SUITE 116, ALTAMONTE SPRINGS, FL, 327014914, US

Contacts
Phone +1 407-647-2009
Fax 4076602009

Authorized person
Name DR. ERIK ROACH
Role PRESIDENT / CEO
Phone 4076472009

Taxonomy
Taxonomy Code 111NN1001X - Nutrition Chiropractor
License Number 9409
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 002190400
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROACH FAMILY CHIROPRACTIC 401(K) & PROFIT SHARING PLAN 2012 260728901 2013-09-17 ROACH FAMILY CHIROPRACTIC, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076472009
Plan sponsor’s address P.O. BOX 947809, MAITLAND, FL, 327947809

Signature of
Role Plan administrator
Date 2013-09-17
Name of individual signing RACHEL ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY CHIROPRACTIC 401(K) & PROFIT SHARING PLAN 2011 260728901 2012-10-24 ROACH FAMILY CHIROPRACTIC, LLC 3
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076472009
Plan sponsor’s address P.O. BOX 947809, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 260728901
Plan administrator’s name ROACH FAMILY CHIROPRACTIC, LLC
Plan administrator’s address P.O. BOX 947809, ALTAMONTE SPRINGS, FL, 32701
Administrator’s telephone number 4076472009

Signature of
Role Plan administrator
Date 2012-10-24
Name of individual signing RACHEL ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY CHIROPRACTIC 401(K) & PROFIT SHARING PLAN 2011 260728901 2012-10-24 ROACH FAMILY CHIROPRACTIC, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076472009
Plan sponsor’s address P.O. BOX 947809, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 260728901
Plan administrator’s name ROACH FAMILY CHIROPRACTIC, LLC
Plan administrator’s address P.O. BOX 947809, ALTAMONTE SPRINGS, FL, 32701
Administrator’s telephone number 4076472009

Signature of
Role Plan administrator
Date 2012-10-24
Name of individual signing RACHEL ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY CHIROPRACTIC 401(K) & PROFIT SHARING PLAN 2011 260728901 2012-10-12 ROACH FAMILY CHIROPRACTIC, LLC 3
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076472009
Plan sponsor’s address P.O. BOX 947809, ALTAMONTE SPRINGS, FL, 32701

Plan administrator’s name and address
Administrator’s EIN 260728901
Plan administrator’s name ROACH FAMILY CHIROPRACTIC, LLC
Plan administrator’s address P.O. BOX 947809, ALTAMONTE SPRINGS, FL, 32701
Administrator’s telephone number 4076472009

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing RACHEL ROACH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROACH ERIK DDR Agent 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Managing Member

Name Role Address
ROACH RACHEL Managing Member 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2015-09-25 No data No data
REINSTATEMENT 2014-10-06 No data No data
CHANGE OF PRINCIPAL ADDRESS 2014-10-06 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL 32701 No data
CHANGE OF MAILING ADDRESS 2014-10-06 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL 32701 No data
REGISTERED AGENT ADDRESS CHANGED 2014-10-06 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL 32701 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2014-09-26 No data No data
REGISTERED AGENT NAME CHANGED 2008-03-19 ROACH, ERIK D, DR No data

Documents

Name Date
REINSTATEMENT 2014-10-06
ANNUAL REPORT 2013-01-26
ANNUAL REPORT 2012-01-04
ANNUAL REPORT 2011-01-06
ANNUAL REPORT 2010-01-06
ANNUAL REPORT 2009-03-14
ANNUAL REPORT 2008-03-19
Florida Limited Liability 2007-08-07

Related by officers

ROACH RACHEL

RACHEL ROACH, LLC

Related by address

475 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 32701

SLWCHIRODC, LLC

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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