| Entity Name: | FORT WALTON BEACH CHIROPRACTIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 11 Sep 2012 (12 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 03 May 2019 (6 years ago) |
| Document Number: | L12000116450 |
| FEI/EIN Number | 35-2454866 |
| Address: | 315 NE Racetrack Road, FORT WALTON BEACH, FL 32547 |
| Mail Address: | 315 NE Racetrack Road, FORT WALTON BEACH, FL 32547 |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437409885 | 2012-09-13 | 2019-06-19 | 315 RACETRACK RD NE, FORT WALTON BEACH, FL, 325472548, US | 315 RACETRACK RD NE, FORT WALTON BEACH, FL, 325472548, US | |||||||||||||||||
|
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| Phone | +1 850-200-4911 |
Authorized person
| Name | DR. SCOTT SMITH |
| Role | MANAGER |
| Phone | 8502004911 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8625 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FLEET & SMITH | Agent | 1283 N. EGLIN PARKWAY, SUITE A, SHALIMAR, FL 32579 |
| Name | Role | Address |
|---|---|---|
| SMITH, SCOTT R | Manager | 315 NE Racetrack Road, FORT WALTON BEACH, FL 32547 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000068910 | FORT WALTON BEACH CHIROPRACTIC | ACTIVE | 2019-06-18 | 2029-12-31 | No data | 315 NE RACETRACK ROAD, FORT WALTON BEACH, FL, 32547 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC NAME CHANGE | 2019-05-03 | FORT WALTON BEACH CHIROPRACTIC, LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-12 | 315 NE Racetrack Road, FORT WALTON BEACH, FL 32547 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-12 | 315 NE Racetrack Road, FORT WALTON BEACH, FL 32547 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-12 | FLEET & SMITH | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-22 |
| ANNUAL REPORT | 2020-01-22 |
| LC Name Change | 2019-05-03 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-12 |
| ANNUAL REPORT | 2016-01-27 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
