| Entity Name: | CLINICAL CHIROPRACTIC GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Aug 2000 (24 years ago) |
| Document Number: | P00000076676 |
| FEI/EIN Number | 651032588 |
| Address: | 6918 Cypress rd., Plantation, FL, 33317, US |
| Mail Address: | 6918 Cypress rd., Plantation, FL, 33317, US |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669587259 | 2006-08-21 | 2014-09-05 | 6918 CYPRESS RD, PLANTATION, FL, 333172318, US | 6918 CYPRESS RD, PLANTATION, FL, 333172318, US | |||||||||||||||||||||||||
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| Phone | +1 954-701-5194 |
| Fax | 9547015191 |
Authorized person
| Name | DR. WILLIAM RICHARD COOPER |
| Role | OWNER |
| Phone | 7547015194 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH 7805 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 382046700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| COOPER WILLIAM R | Agent | 6918 Cypress rd., Plantation, FL, 33317 |
| Name | Role | Address |
|---|---|---|
| COOPER WILLIAM R | Chief Executive Officer | 6918 Cypress rd., PLANTATION, FL, 33317 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000050025 | DISC CENTERS OF PLANTATION | ACTIVE | 2022-04-20 | 2027-12-31 | No data | 6918 CYPRESS RD., PLANTATION, FL, 33317 |
| G14000065045 | PLANTATION SPINE & REHABILITATION CENTER | ACTIVE | 2014-06-24 | 2029-12-31 | No data | 6918 CYPRESS RD., PLANTATION, FL, 33317 |
| G12000042175 | BOCA SPINE AND PHYSICAL REHABILITATION CENTER | EXPIRED | 2012-05-04 | 2017-12-31 | No data | 21685 STATE RD 7, BOCA RATON, FL, 33428 |
| G11000063980 | WEST BOCA CHIROPRACTIC AND REHABILITATION CENTER | EXPIRED | 2011-06-24 | 2016-12-31 | No data | 21685 STATE RD 7, BOCA RATON, FL, 33428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-08-21 | 6918 Cypress rd., Plantation, FL 33317 | No data |
| CHANGE OF MAILING ADDRESS | 2014-08-21 | 6918 Cypress rd., Plantation, FL 33317 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-08-21 | 6918 Cypress rd., Plantation, FL 33317 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-16 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
