| Entity Name: | SOUTH FLORIDA CHIROPRACTIC AND REHABILITATION, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 May 2003 (22 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 25 Aug 2003 (21 years ago) |
| Document Number: | P03000051624 |
| FEI/EIN Number | 562356078 |
| Address: | BOCA SPINE AND WELLNESS CENTER, 299 WEST CAMINO GARDENS BLVD, SUITE 103A, BOCA RATON, FL, 33432 |
| Mail Address: | BOCA SPINE AND WELLNESS CENTER, 299 WEST CAMINO GARDENS BLVD, SUITE 103A, BOCA RATON, FL, 33432 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003096207 | 2007-11-06 | 2009-07-21 | 299 W. CAMINO GARDENS BLVD, SUITE 103, BOCA RATON, FL, 334325822, US | 299 W. CAMINO GARDENS BLVD, SUITE 103, BOCA RATON, FL, 334325822, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 561-395-9299 |
| Fax | 5613957995 |
Authorized person
| Name | MRS. NATALIA FANO |
| Role | OFFICE MANAGER |
| Phone | 5613959299 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8413 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME37335 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS PIN |
| Number | 79651 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FANO DARREN | Agent | BOCA SPINE AND WELLNESS CENTER, BOCA RATON, FL, 33432 |
| Name | Role | Address |
|---|---|---|
| FANO DARREN | Director | 8861 WENDY LANE SOUTH, ROYAL PALM BEACH, FL, 33411 |
| Name | Role | Address |
|---|---|---|
| Pereyra Natalia C | Vice President | BOCA SPINE AND WELLNESS CENTER, BOCA RATON, FL, 33432 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2003-08-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-08-25 | BOCA SPINE AND WELLNESS CENTER, 299 WEST CAMINO GARDENS BLVD, SUITE 103A, BOCA RATON, FL 33432 | No data |
| CHANGE OF MAILING ADDRESS | 2003-08-25 | BOCA SPINE AND WELLNESS CENTER, 299 WEST CAMINO GARDENS BLVD, SUITE 103A, BOCA RATON, FL 33432 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2003-08-25 | BOCA SPINE AND WELLNESS CENTER, 299 WEST CAMINO GARDENS BLVD, SUITE 103A, BOCA RATON, FL 33432 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-01-22 |
| ANNUAL REPORT | 2019-05-07 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-04-18 |
| ANNUAL REPORT | 2015-02-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
