| Entity Name: | NELSON CHIROPRACTIC & REHABILITATION LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Mar 2010 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Sep 2017 (7 years ago) |
| Document Number: | L10000035477 |
| FEI/EIN Number | 800577261 |
| Address: | 905 WEST VENTURA AVENUE, CLEWISTON, FL, 33440 |
| Mail Address: | 905 WEST VENTURA AVENUE, CLEWISTON, FL, 33440 |
| ZIP code: | 33440 |
| County: | Hendry |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003110818 | 2011-01-08 | 2013-01-25 | 905 W VENTURA AVE, CLEWISTON, FL, 334403411, US | 905 W VENTURA AVE, CLEWISTON, FL, 334403411, US | |||||||||||||||||||||||||||
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| Phone | +1 863-983-8291 |
| Fax | 8639832283 |
| Phone | +1 863-983-8391 |
Authorized person
| Name | RYAN NELSON |
| Role | PRESIDENT |
| Phone | 8639838391 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| License Number | CH9995 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002282701 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NELSON RYAN | Agent | 905 WEST VENTURA AVENUE, CLEWISTON, FL, 33440 |
| Name | Role | Address |
|---|---|---|
| NELSON RYAN | Manager | 905 WEST VENTURA AVENUE, CLEWISTON, FL, 33440 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2017-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-09-26 | NELSON, RYAN | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-19 | 905 WEST VENTURA AVENUE, CLEWISTON, FL 33440 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-19 | 905 WEST VENTURA AVENUE, CLEWISTON, FL 33440 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-19 | 905 WEST VENTURA AVENUE, CLEWISTON, FL 33440 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-16 |
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-03-09 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-01-08 |
| ANNUAL REPORT | 2018-01-10 |
| REINSTATEMENT | 2017-09-26 |
| ANNUAL REPORT | 2016-03-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
