| Entity Name: | ADVANCED CHIROPRACTIC REHABILITATION AND WELLNESS CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 23 Jul 2004 (21 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P04000109660 |
| FEI/EIN Number | 510519313 |
| Address: | 15151 SOUTH HWY 441, SUMMERFIELD, FL, 34491, US |
| Mail Address: | 15151 SOUTH HWY 441, SUMMERFIELD, FL, 34491, US |
| ZIP code: | 34491 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255513602 | 2007-11-28 | 2009-08-05 | 15151 S US HIGHWAY 441, SUITE 200, SUMMERFIELD, FL, 344914481, US | 15151 S US HIGHWAY 441, SUMMERFIELD, FL, 344914481, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 352-307-0033 |
| Fax | 3523071998 |
Authorized person
| Name | DR. THOMAS FRANK MAMMANA |
| Role | OWNER |
| Phone | 3523070033 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH2831 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| License Number | CH2831 |
| State | NY |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 3813525-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MAMMANA THOMAS F | Agent | 9148 se 154th st, Summerfield, FL, 34491 |
| Name | Role | Address |
|---|---|---|
| MAMMANA THOMAS F | President | 15151 HWY 441, SUMMERFIELD, FL, 34491 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000015147 | SUMMERFIELD SPINE AND JOINT SOLUTIONS | EXPIRED | 2011-02-09 | 2016-12-31 | No data | 15151 SOUTH HIGHWAY 441, SUMMERFIELD, FL, 34491 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-30 | 9148 se 154th st, Summerfield, FL 34491 | No data |
| REINSTATEMENT | 2022-09-30 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REINSTATEMENT | 2021-01-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-02-18 | MAMMANA, THOMAS F | No data |
| REINSTATEMENT | 2016-02-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REINSTATEMENT | 2014-12-10 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J12001113136 | TERMINATED | 1000000435270 | MARION | 2012-12-12 | 2022-12-28 | $ 710.61 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ALACHUA SERVICE CENTER, 14107 NW US HIGHWAY 441 STE 100, ALACHUA FL326156390 |
| Name | Date |
|---|---|
| REINSTATEMENT | 2022-09-30 |
| REINSTATEMENT | 2021-01-18 |
| ANNUAL REPORT | 2019-04-06 |
| ANNUAL REPORT | 2018-02-06 |
| ANNUAL REPORT | 2017-02-22 |
| REINSTATEMENT | 2016-02-18 |
| REINSTATEMENT | 2014-12-10 |
| REINSTATEMENT | 2012-10-16 |
| Reinstatement | 2011-02-09 |
| ANNUAL REPORT | 2008-01-23 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
