| Entity Name: | SMITH & SMITH CHIROPRACTIC GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 May 2001 (24 years ago) |
| Document Number: | P01000047174 |
| FEI/EIN Number | 651105713 |
| Address: | 3115 Jodi Lane, Palm Harbor, FL, 34684, US |
| Mail Address: | 3115 Jodi Lane, Palm Harbor, FL, 34684, US |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538323118 | 2008-07-14 | 2011-03-10 | 36434 US HIGHWAY 19 N, PALM HARBOR, FL, 346841330, US | 36434 US HWY 19 N., PALM HARBOR, FL, 346843110, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-785-6771 |
| Fax | 7277810657 |
Authorized person
| Name | DR. RYAN A SMITH |
| Role | VICE PRESIDENT/ OWNER |
| Phone | 7277856771 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8144 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 2800187-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH RYAN | Agent | 3115 JODI LANE, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| SMITH RYAN A | Secretary | 3115 JODI LANE, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| SMITH RYAN A | Vice President | 3115 JODI LANE, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| SMITH RYAN A | Director | 3115 JODI LANE, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| SMITH JACQUELINE B | PTO | 3115 JODI LANE, PALM HARBOR, FL, 34684 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000082023 | HOLISTIC HEALTH AND SPINE | EXPIRED | 2012-08-21 | 2017-12-31 | No data | 36434 U.S. HWY 19 NORTH, PALM HARBOUR, FL, 34684 |
| G10000078809 | CHRONIC CONDITION RELIEF CENTER | EXPIRED | 2010-08-27 | 2015-12-31 | No data | 36434 US HWY 19 NORTH, PALM HARBOR, FL, 34684, US |
| G08011700027 | SCOLIOSIS CORRECTION CENTER OF PALM HARBOR | EXPIRED | 2008-01-11 | 2013-12-31 | No data | 32522 US HWY 19 N, PALM HARBOR, FL, 34684 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
