| Entity Name: | GRASSAM FAMILY CHIROPRACTIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 22 Mar 2001 (24 years ago) |
| Document Number: | P01000029639 |
| FEI/EIN Number | 651089503 |
| Address: | 516 COLORADO AVENUE, STUART, FL, 34994 |
| Mail Address: | 516 South Colorado Avenue, Stuart, FL, 34994, US |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548431638 | 2008-03-17 | 2010-07-21 | PO BOX 1108, STUART, FL, 349951108, US | 1928 SE FEDERAL HWY, STUART, FL, 349943916, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 772-286-5433 |
| Fax | 7722864023 |
Authorized person
| Name | DR. LISA GRASSAM |
| Role | DOCTOR |
| Phone | 7722865433 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8213 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381368100 |
| State | FL |
| Issuer | MEDICARE GROUP |
| Number | K2553 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRASSAM LISA A | Agent | 516 South Colorado Avenue, Stuart, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| GRASSAM LISA A | President | 516 COLORADO AVENUE, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| GRASSAM LISA A | Secretary | 516 COLORADO AVENUE, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| GRASSAM LISA A | Director | 516 COLORADO AVENUE, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| GRASSAM LISA A | Vice President | 516 COLORADO AVENUE, STUART, FL, 34994 |
| Name | Role | Address |
|---|---|---|
| GRASSAM LISA A | Treasurer | 516 COLORADO AVENUE, STUART, FL, 34994 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-04 | 516 COLORADO AVENUE, STUART, FL 34994 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-04 | 516 South Colorado Avenue, Stuart, FL 34994 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-29 | 516 COLORADO AVENUE, STUART, FL 34994 | No data |
| REGISTERED AGENT NAME CHANGED | 2011-04-29 | GRASSAM, LISA A | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-02-14 |
| ANNUAL REPORT | 2021-06-09 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-03-11 |
| ANNUAL REPORT | 2017-05-30 |
| ANNUAL REPORT | 2016-04-29 |
| ANNUAL REPORT | 2015-04-28 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3159858505 | 2021-02-23 | 0455 | PPS | 516 Colorado Ave N/A, Stuart, FL, 34994-3014 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 3878487109 | 2020-04-12 | 0455 | PPP | 516 S Colorado Ave, Stuart, FL, 33994-3014 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Date of last update: 03 Feb 2025
Sources: Florida Department of State
