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ROACH FAMILY WELLNESS, PLLC

Company Details

Entity Name: ROACH FAMILY WELLNESS, PLLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 28 Jul 2016 (9 years ago)
Document Number: L16000139997
FEI/EIN Number 81-3396448
Mail Address: PO BOX 941912, MAITLAND, FL, 32794, US
Address: 623 Maitland Ave, Suite 1101, Altamonte springs, FL, 32701, US
ZIP code: 32701
County: Seminole
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750822821 2017-03-09 2017-03-09 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 327015444, US 475 MAITLAND AVE, ALTAMONTE SPRINGS, FL, 327015444, US

Contacts

Phone +1 407-678-2009

Authorized person

Name DR. ERIK ROACH
Role CEO/OWNER
Phone 4076782009

Taxonomy

Taxonomy Code 111N00000X - Chiropractor
License Number CH 9409
State FL
Is Primary Yes
Taxonomy Code 111N00000X - Chiropractor
License Number CH 10874
State FL
Is Primary No
Taxonomy Code 207P00000X - Emergency Medicine Physician
License Number ME 96405
State FL
Is Primary No
Taxonomy Code 363L00000X - Nurse Practitioner
License Number ARNP 9165596
State FL
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ROACH FAMILY WELLNESS, PLLC 401(K) & PROFIT SHARING PLAN 2023 813396448 2024-02-02 ROACH FAMILY WELLNESS, PLLC 2
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076782009
Plan sponsor’s address P.O. BOX 941912, MAITLAND, FL, 32794
ROACH FAMILY WELLNESS, PLLC 401(K) & PROFIT SHARING PLAN 2023 813396448 2024-02-09 ROACH FAMILY WELLNESS, PLLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076782009
Plan sponsor’s address P.O. BOX 941912, MAITLAND, FL, 32794
ROACH FAMILY WELLNESS, PLLC 401(K) & PROFIT SHARING PLAN 2022 813396448 2024-01-02 ROACH FAMILY WELLNESS, PLLC 2
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076782009
Plan sponsor’s address 623 MAITLAND AVENUE, SUITE 1101, ALTAMONTE SPRINGS, FL, 32701

Signature of

Role Plan administrator
Date 2024-01-02
Name of individual signing LISSETTE ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY WELLNESS, PLLC 401(K) & PROFIT SHARING PLAN 2022 813396448 2023-06-21 ROACH FAMILY WELLNESS, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076782009
Plan sponsor’s address 623 MAITLAND AVENUE, SUITE 1101, ALTAMONTE SPRINGS, FL, 32701

Signature of

Role Plan administrator
Date 2023-06-21
Name of individual signing LISSETTE ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY WELLNESS, PLLC 401(K) & PROFIT SHARING PLAN 2021 813396448 2022-10-04 ROACH FAMILY WELLNESS, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076782009
Plan sponsor’s address 623 MAITLAND AVENUE, SUITE 1101, ALTAMONTE SPRINGS, FL, 32701

Signature of

Role Plan administrator
Date 2022-10-04
Name of individual signing LISSETTE ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY WELLNESS,PLLC 401(K) & PROFIT SHARING PLAN 2020 813396448 2021-09-27 ROACH FAMILY WELLNESS,PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076472009
Plan sponsor’s address 623 MAITLAND AVENUE - SUITE 1101, ALTAMONTE SPRINGS, FL, 32701

Signature of

Role Plan administrator
Date 2021-09-27
Name of individual signing ERIK ROACH
Valid signature Filed with authorized/valid electronic signature
ROACH FAMILY WELLNESS,PLLC 401(K) & PROFIT SHARING PLAN 2019 813396448 2020-09-30 ROACH FAMILY WELLNESS,PLLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621310
Sponsor’s telephone number 4076472009
Plan sponsor’s address 623 MAITLAND AVENUE - SUITE 1101, ALTAMONTE SPRINGS, FL, 32701

Signature of

Role Plan administrator
Date 2020-09-30
Name of individual signing ERIK ROACH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROACH ERIK D Agent 623 Maitland Ave, Altamonte springs, FL, 32701

Manager

Name Role Address
ROACH ERIK D Manager 623 Maitland Ave, Altamonte springs, FL, 32701

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G23000069088 ROACH SPINE AND DISC CENTER ACTIVE 2023-06-06 2028-12-31 No data PO BOX 941912, MAITLAND, FL, 32794
G17000072033 ROACH FAMILY WELLNESS EXPIRED 2017-07-03 2022-12-31 No data 475, ALTAMONTE SPRINGS, FL, 32701

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2022-05-03 623 Maitland Ave, Suite 1101, Altamonte springs, FL 32701 No data
CHANGE OF PRINCIPAL ADDRESS 2021-03-13 623 Maitland Ave, Suite 1101, Altamonte springs, FL 32701 No data
REGISTERED AGENT ADDRESS CHANGED 2021-03-13 623 Maitland Ave, Suite 1101, Altamonte springs, FL 32701 No data

Documents

Name Date
ANNUAL REPORT 2024-02-21
ANNUAL REPORT 2023-03-06
ANNUAL REPORT 2022-05-03
ANNUAL REPORT 2021-03-13
ANNUAL REPORT 2020-02-05
ANNUAL REPORT 2019-04-08
ANNUAL REPORT 2018-06-01
ANNUAL REPORT 2017-02-12
Florida Limited Liability 2016-07-28

Date of last update: 02 Feb 2025

Sources: Florida Department of State