| Entity Name: | MASTERSON CHIROPRACTIC, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Jul 2004 (21 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 15 Jun 2009 (16 years ago) |
| Document Number: | P04000100939 |
| FEI/EIN Number | 201330386 |
| Address: | 190 SOUTH UNIVERSITY DRIVE, PEMBROKE PINES, FL, 33025, US |
| Mail Address: | 4991 SW 119th Ave, Cooper City, FL, 33330, US |
| ZIP code: | 33025 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043360076 | 2007-01-11 | 2013-04-01 | 4991 SW 119TH AVE, COOPER CITY, FL, 333305425, US | 190 S UNIVERSITY DR, PEMBROKE PINES, FL, 330252234, US | |||||||||||||||||||||||||
|
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| Phone | +1 954-392-7703 |
| Fax | 9544338268 |
Authorized person
| Name | DR. JOSEPH CRAIG MASTERSON |
| Role | CHIROPRACTOR |
| Phone | 9543927703 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8706 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381896900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Masterson Joseph C | Agent | 4991 SW 119th Ave, Cooper City, FL, 33330 |
| Name | Role | Address |
|---|---|---|
| MASTERSON JOSEPH C | President | 4991 SW 119th Ave, Cooper City, FL, 33330 |
| Name | Role | Address |
|---|---|---|
| MASTERSON JOSEPH C | Secretary | 4991 SW 119th Ave, Cooper City, FL, 33330 |
| Name | Role | Address |
|---|---|---|
| MASTERSON JOSEPH C | Director | 4991 SW 119th Ave, Cooper City, FL, 33330 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2015-04-28 | Masterson, Joseph C | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-28 | 4991 SW 119th Ave, Cooper City, FL 33330 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-22 | 190 SOUTH UNIVERSITY DRIVE, PEMBROKE PINES, FL 33025 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-22 | 190 SOUTH UNIVERSITY DRIVE, PEMBROKE PINES, FL 33025 | No data |
| CANCEL ADM DISS/REV | 2009-06-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-09 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-03-24 |
| ANNUAL REPORT | 2019-02-26 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-01-17 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
