| Entity Name: | MIAMI BEACH NATURAL SPORTS MEDICINE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 05 Dec 2001 (23 years ago) |
| Document Number: | P01000114987 |
| FEI/EIN Number | 651159138 |
| Address: | 975 ARTHUR GODFREY ROAD, MIAMI BEACH, FL, 33140, US |
| Mail Address: | 975 ARTHUR GODFREY ROAD, MIAMI BEACH, FL, 33140, US |
| ZIP code: | 33140 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689786113 | 2006-08-31 | 2012-12-05 | 400 ARTHUR GODFREY RD, SUITE 412, MIAMI BEACH, FL, 331403516, US | 400 ARTHUR GODFREY RD, SUITE 412, MIAMI BEACH, FL, 331403516, US | |||||||||||||||||||||||||
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| Phone | +1 305-672-2225 |
| Fax | 3056744449 |
Authorized person
| Name | DR. TODD MITCHELL NARSON |
| Role | PRESIDENT |
| Phone | 3056722225 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH0006376 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 380939100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHEVLIN BARRY T | Agent | 1111 KANE CONCOURSE, BAY HARBOR ISLANDS, FL, 33154 |
| Name | Role | Address |
|---|---|---|
| NARSON TODD | President | 975 ARTHUR GODREY RD, MIAMI BEACH, FL, 33140 |
| Name | Role | Address |
|---|---|---|
| NARSON COREY | Vice President | 975 ARTHUR GODFREY RD #102, MIAMI BEACH, FL, 33140 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000018264 | MIAMI BEACH FAMILY & SPORTS CHIROPRACTIC CENTER | ACTIVE | 2014-02-20 | 2029-12-31 | No data | 975 ARTHUR GODFREY ROAD, STE 102, MIAMI BEACH, FL, 33140 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2020-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
