| Entity Name: | GNV CHIRO, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 28 Jan 2020 (5 years ago) |
| Document Number: | L20000034074 |
| FEI/EIN Number | 84-4607801 |
| Address: | 1591 NW 150th St, Trenton, FL 32693 |
| Mail Address: | 1591 NW 150th St, Trenton, FL 32693 |
| ZIP code: | 32693 |
| County: | Gilchrist |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588288260 | 2020-05-29 | 2020-06-01 | 5745 SW 75TH ST NUM 275, GAINESVILLE, FL, 326085504, US | 5745 SW 75TH ST NUM 275, GAINESVILLE, FL, 326085504, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 352-949-0843 |
Authorized person
| Name | MR. JOSHUA M WILSON |
| Role | OWNER/CHIROPRACTOR |
| Phone | 3529490843 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104032700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILSON, JOSHUA M | Agent | 1591 NW 150th St, Trenton, FL 32693 |
| Name | Role | Address |
|---|---|---|
| WILSON, JOSHUA M, DR. | Authorized Member | 1591 NW 150th St, Trenton, FL 32693 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000101932 | CHIROPRACTIC DELIVERED | ACTIVE | 2021-08-05 | 2026-12-31 | No data | 2271 NW 145TH DR, NEWBERRY, FL, 32669 |
| G20000133437 | GAINESVILLE MOBILE CHIROPRACTIC | ACTIVE | 2020-10-14 | 2025-12-31 | No data | 2271 NW 145TH DR, NEWBERRY, FL, 32669 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-13 | 1591 NW 150th St, Trenton, FL 32693 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-13 | 1591 NW 150th St, Trenton, FL 32693 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-13 | 1591 NW 150th St, Trenton, FL 32693 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2021-04-09 |
| Florida Limited Liability | 2020-01-28 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
