| Entity Name: | TAMARA BURKHEAD D.C., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 01 Jul 2016 (9 years ago) |
| Date of dissolution: | 31 Dec 2020 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 31 Dec 2020 (4 years ago) |
| Document Number: | L16000125926 |
| FEI/EIN Number | 81-3188080 |
| Address: | 1102 W. JEFFERSON ST., QUINCY, FL, 32351, US |
| Mail Address: | 1102 W. JEFFERSON ST., QUINCY, FL, 32351, US |
| ZIP code: | 32351 |
| County: | Gadsden |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730626177 | 2017-01-24 | 2017-01-24 | 1102 W JEFFERSON ST, QUINCY, FL, 323512212, US | 1102 W JEFFERSON ST, QUINCY, FL, 323512212, US | |||||||||||||||||||||||||
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| Phone | +1 850-875-1747 |
| Fax | 8506273853 |
Authorized person
| Name | DR. TAMARA BURKHEAD |
| Role | OWNER |
| Phone | 8508751747 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10451 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004395600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| RUDOLPH JOHN A | Agent | 207 WEST PARK AVE., TALLAHASSEE, FL, 32301 |
| Name | Role | Address |
|---|---|---|
| BURKHEAD TAMARA LDR. | Manager | 173 BEAVER CREEK RD, HAVANA, FL, 32333 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-12-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-12-31 |
| ANNUAL REPORT | 2018-04-16 |
| ANNUAL REPORT | 2017-09-15 |
| Florida Limited Liability | 2016-07-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
