| Entity Name: | BENNETT CHIROPRACTIC & WELLNESS CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 15 Jun 2004 (21 years ago) |
| Document Number: | P04000092455 |
| FEI/EIN Number | 201296291 |
| Address: | 3725 Bonita Beach Rd. SW., Bonita Springs, FL, 34134, US |
| Mail Address: | 3725 Bonita Beach Rd. SW, Bonita Springs, FL, 34134, US |
| ZIP code: | 34134 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073796207 | 2007-12-11 | 2023-05-22 | 3725 BONITA BEACH RD STE 4, BONITA SPRINGS, FL, 341341400, US | 3725 BONITA BEACH RD STE 4, BONITA SPRINGS, FL, 341341400, US | |||||||||||||||||||||||
|
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| Phone | +1 239-763-1288 |
Authorized person
| Name | DR. NICOLE MICHELLE BENNETT |
| Role | PRESIDENT |
| Phone | 2397631288 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8675 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381769501 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BENNETT DR. NICOLE | Agent | 3725 Bonita Beach Rd. SW., Bonita Springs, FL, 34134 |
| Name | Role | Address |
|---|---|---|
| BENNETT DR. NICOLE | President | 3725 Bonita Beach Rd. SW., Bonita Springs, FL, 34134 |
| Name | Role | Address |
|---|---|---|
| BENNETT JOHN A | Vice President | 11 Avenida Carita, FORT MYERS BEACH, FL, 33931 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000082789 | BEACH CHIROPRACTIC AND WELLNESS CENTER INC. | EXPIRED | 2014-08-12 | 2019-12-31 | No data | 7130 ESTERO BLVD., SUITE 1, FORT MYERS BEACH, FL, 33931 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-06-07 | 3725 Bonita Beach Rd. SW., Suite 4, Bonita Springs, FL 34134 | No data |
| CHANGE OF MAILING ADDRESS | 2023-06-07 | 3725 Bonita Beach Rd. SW., Suite 4, Bonita Springs, FL 34134 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-06-07 | 3725 Bonita Beach Rd. SW., Suite 4, Bonita Springs, FL 34134 | No data |
| REGISTERED AGENT NAME CHANGED | 2008-03-13 | BENNETT, DR. NICOLE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| AMENDED ANNUAL REPORT | 2023-06-07 |
| ANNUAL REPORT | 2023-02-08 |
| ANNUAL REPORT | 2022-02-06 |
| ANNUAL REPORT | 2021-03-25 |
| ANNUAL REPORT | 2020-03-13 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-01-31 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
