| Entity Name: | DISC CENTER OF PORT ST LUCIE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 29 Jun 2022 (3 years ago) |
| Document Number: | L22000292707 |
| FEI/EIN Number | 88-3155900 |
| Address: | 555 NW Lake Whitney PL, Port St. Lucie, FL, 34986, US |
| Mail Address: | 555 NW Lake Whitney PL, Port St. Lucie, FL, 34986, US |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992421002 | 2022-10-19 | 2022-12-01 | 555 NW LAKE WHITNEY PL STE 105, PORT ST LUCIE, FL, 349861623, US | 555 NW LAKE WHITNEY PL STE 105, PORT ST LUCIE, FL, 349861623, US | |||||||||||||
|
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| Phone | +1 772-237-2080 |
Authorized person
| Name | DR. JOHN GRASSAM |
| Role | MANAGER |
| Phone | 7722372080 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BRECHBILL MARK | Agent | 215 SW FEDERAL HWY STE 200, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| GRASSAM JOHN R | Manager | 555 NW Lake Whitney PL, Port St. Lucie, FL, 34986 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-17 | 555 NW Lake Whitney PL, Suite 105, Port St. Lucie, FL 34986 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-17 | 555 NW Lake Whitney PL, Suite 105, Port St. Lucie, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-04-17 |
| Florida Limited Liability | 2022-06-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
