| Entity Name: | JACK CACIC & COMPANY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Apr 2001 (24 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 24 Oct 2003 (21 years ago) |
| Document Number: | P01000034789 |
| FEI/EIN Number | 651091767 |
| Address: | 17 NORTH H STREET, LAKE WORTH, FL, 33460 |
| Mail Address: | 17 NORTH H STREET, LAKE WORTH, FL, 33460 |
| ZIP code: | 33460 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912102021 | 2007-06-19 | 2020-08-22 | 17 N H ST, LAKE WORTH, FL, 334603701, US | 17 N H ST, LAKE WORTH, FL, 334603701, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 561-547-2210 |
| Fax | 5615472210 |
Authorized person
| Name | DR. JACK JOSEPH CACIC |
| Role | PRESIDENT OWNER |
| Phone | 5615472210 |
Taxonomy
| Taxonomy Code | 111NR0400X - Rehabilitation Chiropractor |
| License Number | CH7724 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 111NS0005X - Sports Physician Chiropractor |
| License Number | CH7724 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 54015 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CACIC JACK | Agent | 17 NORTH H STREET, LAKE WORTH, FL, 33460 |
| Name | Role | Address |
|---|---|---|
| CACIC JACK J | President | 17 NORTH H STREET, LAKE WORTH, FL, 33460 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CANCEL ADM DISS/REV | 2003-10-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-10-24 | 17 NORTH H STREET, LAKE WORTH, FL 33460 | No data |
| CHANGE OF MAILING ADDRESS | 2003-10-24 | 17 NORTH H STREET, LAKE WORTH, FL 33460 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-10-24 | 17 NORTH H STREET, LAKE WORTH, FL 33460 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2022-02-25 |
| ANNUAL REPORT | 2021-02-08 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-02-07 |
| ANNUAL REPORT | 2017-02-16 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-03-11 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
