| Entity Name: | DEER CREEK MEDICAL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Apr 2015 (10 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L15000076829 |
| FEI/EIN Number | 47-3894600 |
| Address: | 1761 W HILLSBORO BLVD, SUITE 329, DEERFIELD BEACH, FL, 33442, US |
| Mail Address: | PO BOX 4102, DEERFIELD BEACH, FL, 33442, US |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073978318 | 2015-12-30 | 2015-12-30 | PO BOX 4102, DEERFIELD BEACH, FL, 334424102, US | 3401 DEER CREEK COUNTRY CLUB BLVD, SUITE B, DEERFIELD BEACH, FL, 334428427, US | |||||||||||||||||||
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| Phone | +1 954-531-0420 |
| Fax | 9545310268 |
Authorized person
| Name | DR. MICHAEL R BASTKOWSKI |
| Role | PRFESIDENT |
| Phone | 9545310420 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH7166 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BASTKOWSKI MICHAEL | Agent | 1761 W HILLSBORO BLVD, DEERFIELD BEACH, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| BASTKOWSKI MICHAEL | Managing Member | 1761 W HILLSBORO BLVD, DEERFIELD BEACH, FL, 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-24 | 1761 W HILLSBORO BLVD, SUITE 329, DEERFIELD BEACH, FL 33442 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-24 | 1761 W HILLSBORO BLVD, SUITE 329, DEERFIELD BEACH, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-18 | 1761 W HILLSBORO BLVD, SUITE 329, DEERFIELD BEACH, FL 33442 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-24 | BASTKOWSKI, MICHAEL | No data |
| REINSTATEMENT | 2016-10-24 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-03-18 |
| REINSTATEMENT | 2016-10-24 |
| Florida Limited Liability | 2015-04-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
