| Entity Name: | BLOSSOM FAMILY CHIROPRACTIC PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Feb 2016 (9 years ago) |
| Document Number: | L16000019547 |
| FEI/EIN Number | 81-1299758 |
| Address: | 360 Central Ave, Saint Petersburg, FL, 33701, US |
| Mail Address: | 360 Central Ave, Saint Petersburg, FL, 33701, US |
| ZIP code: | 33701 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043663693 | 2016-07-19 | 2016-07-19 | 360 CENTRAL AVE, STE 480, SAINT PETERSBURG, FL, 337013857, US | 360 CENTRAL AVE, STE 480, SAINT PETERSBURG, FL, 337013857, US | |||||||||||||||||
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| Phone | +1 727-498-5643 |
Authorized person
| Name | DR. SAVANNAH IRBY FORD |
| Role | OWNER/ CHIROPRACTOR |
| Phone | 8135052671 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH 11817 |
| State | FL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLOSSOM FAMILY CHIROPRACTIC PLLC RETIREMENT TRUST | 2023 | 811299758 | 2024-12-20 | BLOSSOM FAMILY CHIROPRACTIC PLLC | 4 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-12-21 |
| Name of individual signing | PLAN SPONSOR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2023-01-01 |
| Business code | 541600 |
| Sponsor’s telephone number | 9544611422 |
| Plan sponsor’s address | 360 CENTRAL AVE STE 1200, ST. PETERSBURG, FL, 33701 |
Signature of
| Role | Plan administrator |
| Date | 2024-07-31 |
| Name of individual signing | PLAN SPONSOR |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| SPIEGEL & UTRERA, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| SAVANNAH IRBY FORD | Secretary | 1470 52nd Ave NE, St. Petersburg, FL, 33703 |
| Name | Role | Address |
|---|---|---|
| SAVANNAH IRBY FORD | Manager | 1470 52nd Ave NE, St. Petersburg, FL, 33703 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-12-22 | 360 Central Ave, Ste 1200, Saint Petersburg, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2022-12-22 | 360 Central Ave, Ste 1200, Saint Petersburg, FL 33701 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-07-26 |
| ANNUAL REPORT | 2020-06-08 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-11 |
| ANNUAL REPORT | 2017-08-07 |
| Florida Limited Liability | 2016-02-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
