| Entity Name: | MOBILE CHIROPRACTIC OF THE PALM BEACHES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Jun 2005 (20 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P05000080700 |
| FEI/EIN Number | 300321491 |
| Address: | 520 34TH ST., WEST PALM BEACH, FL, 33407 |
| Mail Address: | 520 34TH ST., WEST PALM BEACH, FL, 33407 |
| ZIP code: | 33407 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205952892 | 2007-03-22 | 2020-08-22 | 9291 NUGENT TRL, WEST PALM BEACH, FL, 334116327, US | 9291 NUGENT TRL, WEST PALM BEACH, FL, 334116327, US | |||||||||||||||||||||||||
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| Phone | +1 561-333-4442 |
| Fax | 5614227870 |
Authorized person
| Name | DR. DAVID J DORFMAN |
| Role | OFFICER |
| Phone | 5613334442 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH0007334 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 55570 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DORFMAN DAVID J | Agent | 520 34TH ST., WEST PALM BEACH, FL, 33407 |
| Name | Role | Address |
|---|---|---|
| DORFMAN DAVID J | President | 520 34TH ST., WEST PALM BEACH, FL, 33407 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-30 | 520 34TH ST., WEST PALM BEACH, FL 33407 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-30 | 520 34TH ST., WEST PALM BEACH, FL 33407 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-30 | 520 34TH ST., WEST PALM BEACH, FL 33407 | No data |
| CANCEL ADM DISS/REV | 2010-01-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2011-04-30 |
| REINSTATEMENT | 2010-01-04 |
| ANNUAL REPORT | 2008-04-09 |
| ANNUAL REPORT | 2007-05-17 |
| ANNUAL REPORT | 2006-07-24 |
| Domestic Profit | 2005-06-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
