| Entity Name: | SPINAL CHIROPRACTIC INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 May 2002 (23 years ago) |
| Document Number: | P02000051427 |
| FEI/EIN Number | 431960613 |
| Address: | 753 ne 4th ave, FORT LAUDERDALE, FL, 33304, US |
| Mail Address: | 753 ne 4th ave, FORT LAUDERDALE, FL, 33301, US |
| ZIP code: | 33304 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518056985 | 2006-10-12 | 2020-08-22 | 3155 N PALM AIRE DR, #205, POMPANO BEACH, FL, 33069, US | 3155 N PALM AIRE DR, #205, POMPANO BEACH, FL, 33069, US | |||||||||||||||||||||||||
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| Phone | +1 954-917-4095 |
| Fax | 9549174095 |
Authorized person
| Name | MR. CARL RICHARD MOSSO |
| Role | OWNER DOCTOR |
| Phone | 9549174095 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | 006643 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 55143 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOSSO CARL RICHARD | Agent | 753 NE 4TH AVE, FT LAUDERDALE, FL, 33304 |
| Name | Role | Address |
|---|---|---|
| MOSSO CARL R | President | 753 NE 4TH AVE, FT LAUDERDALE, FL, 33304 |
| Name | Role | Address |
|---|---|---|
| Mosso Terezinha | Vice President | 753 ne 4th ave, FORT LAUDERDALE, FL, 33301 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-10 | 753 ne 4th ave, FORT LAUDERDALE, FL 33304 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-10 | 753 ne 4th ave, FORT LAUDERDALE, FL 33304 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-29 | 753 NE 4TH AVE, FT LAUDERDALE, FL 33304 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-04-09 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-06-12 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
