| Entity Name: | WELLNESS WORX CENTER, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 13 Apr 2010 (15 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: | L10000040125 |
| FEI/EIN Number | 272347046 |
| Address: | 3006 Gulf to bay blvd, CLEARWATER, FL, 33759, US |
| Mail Address: | 3006 Gulf to bay blvd, CLEARWATER, FL, 33759, US |
| ZIP code: | 33759 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871819870 | 2010-04-15 | 2010-04-15 | 2495 ENTERPRISE RD, STE104, CLEARWATER, FL, 337631795, US | 2495 ENTERPRISE RD, STE104, CLEARWATER, FL, 337631795, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-474-9729 |
| Fax | 7274749947 |
Authorized person
| Name | DR. GLEN CHARLES PETTERSEN |
| Role | OWNER |
| Phone | 7274749729 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8923 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8772 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | CIGNA |
| Number | 9067913 |
| State | FL |
| Issuer | AMERICAN SPECIALTY HEALTH |
| Number | 1038157 |
| State | FL |
| Issuer | FIRST HEALTH |
| Number | 1147626 |
| State | FL |
| Issuer | AETNA |
| Number | 1538210 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD OF FL |
| Number | 71494 |
| State | FL |
| Issuer | UNITED HEALTH CARE |
| Number | 656080 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| groteke eric k | Agent | 3006 Gulf to bay blvd, CLEARWATER, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| GROTEKE ERIC | Manager | 3006 Gulf to bay blvd, CLEARWATER, FL, 33759 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000076250 | DIAGNOSTIC INJURY SOLUTIONS | EXPIRED | 2011-08-01 | 2016-12-31 | No data | 2495 ENTERPRISE RD, SUITE 104, CLEARWATER, FL, 33763 |
| G11000072939 | LIFE CARE PLAN SOLUTIONS | EXPIRED | 2011-07-21 | 2016-12-31 | No data | 2495 ENTERPRISE RD, SUITE 104, CLEARWATER, FL, 33763 |
| G11000011989 | DIAGNOSTIC PAIN SOLUTIONS | EXPIRED | 2011-01-31 | 2016-12-31 | No data | 2495 ENTERPRISE RD, SUITE104, CLEARWATER, FL, 33763 |
| G10000075327 | OCCU-SPINA SOLUTIONS | EXPIRED | 2010-08-16 | 2015-12-31 | No data | 2495 ENTERPRISE RD STE 104, CLEARWATER, FL, 33763 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-04-30 | 3006 Gulf to bay blvd, CLEARWATER, FL 33759 | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-30 | 3006 Gulf to bay blvd, CLEARWATER, FL 33759 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-04-30 | groteke, eric k | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-30 | 3006 Gulf to bay blvd, CLEARWATER, FL 33759 | No data |
| LC AMENDMENT | 2011-12-29 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-30 |
| ANNUAL REPORT | 2013-03-30 |
| ANNUAL REPORT | 2012-02-20 |
| LC Amendment | 2011-12-29 |
| ANNUAL REPORT | 2011-03-21 |
| Florida Limited Liability | 2010-04-13 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
