| Entity Name: | INCLEDON CHIROPRACTIC, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 02 Jan 2002 (23 years ago) |
| Document Number: | P02000000372 |
| FEI/EIN Number | 800006169 |
| Address: | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL, 33437, US |
| Mail Address: | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL, 33437, US |
| ZIP code: | 33437 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043538135 | 2010-05-13 | 2015-10-29 | 6609 WOOLBRIGHT RD, SUITE 414, BOYNTON BEACH, FL, 334370910, US | 6609 WOOLBRIGHT RD, SUITE 414, BOYNTON BEACH, FL, 334370910, US | |||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 561-865-8390 |
| Fax | 5618651730 |
Authorized person
| Name | JAMES DAREN INCLEDON |
| Role | PRESIDENT |
| Phone | 5618658390 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH7416 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 3818900-00 |
| State | FL |
| Issuer | UNITED HEALTHCARE |
| Number | 604421 |
| State | FL |
| Issuer | OXFORD |
| Number | P2586587 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DR3227 |
| State | FL |
| Issuer | BLUE CROSS |
| Number | 53941 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| INCLEDON JAMES D | Agent | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL, 33437 |
| Name | Role | Address |
|---|---|---|
| INCLEDON JAMES D | President | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL, 33437 |
| Name | Role | Address |
|---|---|---|
| INCLEDON JAMES D | Director | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL, 33437 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-18 | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL 33437 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-18 | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL 33437 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-18 | 6609 WOOLBRIGHT ROAD, SUITE 414, BOYNTON BEACH, FL 33437 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-03-14 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-04-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
