| Entity Name: | COOK CHIROPRACTIC CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 10 Mar 2016 (9 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: | L16000050483 |
| FEI/EIN Number | 81-1824506 |
| Address: | 309 CENTRAL AVENUE, CLEWISTON, FL, 33440, US |
| Mail Address: | 309 CENTRAL AVENUE, CLEWISTON, FL, 33440, US |
| ZIP code: | 33440 |
| County: | Hendry |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508351032 | 2018-06-27 | 2018-12-19 | 2795 RIVER RD, MOORE HAVEN, FL, 334716446, US | 309 CENTRAL AVE, CLEWISTON, FL, 334403703, US | |||||||||||||||||||||||||
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| Phone | +1 863-233-6084 |
| Fax | 8634551513 |
Authorized person
| Name | DR. JENNIFER COOK |
| Role | OWNER |
| Phone | 8632336084 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10391 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004141900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COOK JENNIFER A | Agent | 309 Central Avenue, CLEWISTON, FL, 33440 |
| Name | Role | Address |
|---|---|---|
| COOK JENNIFER ADr. | Owne | 309 CENTRAL AVENUE, CLEWISTON, FL, 33440 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-17 | 309 Central Avenue, CLEWISTON, FL 33440 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-04-17 |
| Florida Limited Liability | 2016-03-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
