| Entity Name: | KELLERMAN FAMILY CHIROPRACTIC INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 31 Mar 2004 (21 years ago) |
| Date of dissolution: | 04 Feb 2020 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 04 Feb 2020 (5 years ago) |
| Document Number: | P04000055123 |
| FEI/EIN Number | 20-0935732 |
| Mail Address: | 7554 VIA LURIA, LAKE WORTH, FL 33467 |
| Address: | 7554 Via Luria, LAKE WORTH, FL 33467 |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750468195 | 2006-11-01 | 2017-01-30 | 410 E PROSPECT RD, OAKLAND PARK, FL, 333342970, US | 410 E PROSPECT RD, OAKLAND PARK, FL, 333341423, US | |||||||||||||||||||||||||
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| Phone | +1 954-561-4700 |
| Fax | 9545610812 |
Authorized person
| Name | DR. DOUGLAS KELLERMAN |
| Role | PRESIDENT |
| Phone | 5612968484 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8001 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 53928 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BERK, SHARI | Agent | 9569 POSITANO WAY, LAKE WORTH, FL 33467 |
| Name | Role | Address |
|---|---|---|
| KELLERMAN, DOUGLAS | President | 7554 VIA LURIA, LAKE WORTH, FL 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2020-02-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-04-20 | 7554 Via Luria, LAKE WORTH, FL 33467 | No data |
| CHANGE OF MAILING ADDRESS | 2005-01-20 | 7554 Via Luria, LAKE WORTH, FL 33467 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2020-02-04 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-07-03 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-04-30 |
| ANNUAL REPORT | 2014-04-11 |
| ANNUAL REPORT | 2013-04-06 |
| ANNUAL REPORT | 2012-01-23 |
| ANNUAL REPORT | 2011-04-20 |
Date of last update: 05 Jan 2025
Sources: Florida Department of State
