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  5. DAVIS CLINIC OF CHIROPRACTIC, INC.

DAVIS CLINIC OF CHIROPRACTIC, INC.

Company Details

Entity Name: DAVIS CLINIC OF CHIROPRACTIC, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Inactive
Date Filed: 25 Jan 2006 (19 years ago)
Date of dissolution: 06 May 2013 (12 years ago)
Last Event: CONVERSION
Event Date Filed: 06 May 2013 (12 years ago)
Document Number: P06000011593
FEI/EIN Number 20-4643941
Address: 1585 SANTA BARBRA BLVD,, SUITE A, THE VILLAGES, FL 32159
Mail Address: 1585 SANTA BARBRA BLVD, SUITE A, THE VILLAGES, FL 32159
ZIP code: 32159
County: Lake
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1174554265 2006-07-06 2011-05-02 1585 SANTA BARBARA BLVD, SUITE A, LADY LAKE, FL, 321596820, US 1585 SANTA BARBARA BLVD, SUITE A, LADY LAKE, FL, 321596820, US

Contacts
Phone +1 352-430-2121
Fax 3524302114

Authorized person
Name DR. JASON ERIC DAVIS
Role CHIROPRACTIC PHYSICIAN
Phone 3524302121

Taxonomy
Taxonomy Code 111N00000X - Chiropractor
License Number CH8681
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2019 204643941 2020-08-21 DAVIS CLINIC OF CHIROPRACTIC, INC. 38
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 32159
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2018 204643941 2019-08-28 DAVIS CLINIC OF CHIROPRACTIC, INC. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 32159
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2017 204643941 2018-07-12 DAVIS CLINIC OF CHIROPRACTIC, INC. 36
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 32159
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2016 204643941 2017-07-25 DAVIS CLINIC OF CHIROPRACTIC, INC. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 321596820

Signature of
Role Plan administrator
Date 2017-07-25
Name of individual signing SHARY WEIS
Valid signature Filed with authorized/valid electronic signature
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2015 204643941 2016-10-17 DAVIS CLINIC OF CHIROPRACTIC, INC. 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 321596820

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing SHARY WEIS
Valid signature Filed with authorized/valid electronic signature
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2014 204643941 2015-10-14 DAVIS CLINIC OF CHIROPRACTIC, INC. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 321596820

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing JASON E. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2013 204643941 2014-10-02 DAVIS CLINIC OF CHIROPRACTIC, INC. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 321596820

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing JASON E. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS CLINIC OF CHIROPRACTIC, INC. 401(K) PLAN 2012 204643941 2013-10-01 DAVIS CLINIC OF CHIROPRACTIC, INC. 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, THE VILLAGES, FL, 321596820

Signature of
Role Plan administrator
Date 2013-10-01
Name of individual signing JASON E. DAVIS
Valid signature Filed with authorized/valid electronic signature
DAVIS CLINIC OF CHIROPRACTIC, INC. PROFIT SHARING PLAN 2009 204643941 2010-06-04 DAVIS CLINIC OF CHIROPRACTIC, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621310
Sponsor’s telephone number 3524302121
Plan sponsor’s address 1585 SANTA BARBARA BLVD., SUITE A, LADY LAKE, FL, 32159

Plan administrator’s name and address
Administrator’s EIN 204643941
Plan administrator’s name DAVIS CLINIC OF CHIROPRACTIC, INC.
Plan administrator’s address 1585 SANTA BARBARA BLVD., SUITE A, LADY LAKE, FL, 32159
Administrator’s telephone number 3524302121

Signature of
Role Plan administrator
Date 2010-06-03
Name of individual signing DEANNA DAVIS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
UDICK, ARLENE C Agent 39245 TACOMA DRIVE, LADY LAKE, FL 32159

President

Name Role Address
DAVIS, JASON E President 1585 SANTA BARBRA BLVD, STE A, THE VILLAGES, FL 32159

Director

Name Role Address
DAVIS, JASON E Director 1585 SANTA BARBRA BLVD, STE A, THE VILLAGES, FL 32159
DAVIS, DEANNA Director 1585 SANTA BARBRA BLVD, STE A, THE VILLAGES, FL 32159

Secretary

Name Role Address
DAVIS, DEANNA Secretary 1585 SANTA BARBRA BLVD, STE A, THE VILLAGES, FL 32159

Treasurer

Name Role Address
DAVIS, DEANNA Treasurer 1585 SANTA BARBRA BLVD, STE A, THE VILLAGES, FL 32159

Events

Event Type Filed Date Value Description
CONVERSION 2013-05-06 No data CONVERSION MEMBER. RESULTING CORPORATION WAS L13000066660. CONVERSION NUMBER 100000131461
CHANGE OF PRINCIPAL ADDRESS 2011-03-10 1585 SANTA BARBRA BLVD,, SUITE A, THE VILLAGES, FL 32159 No data
CHANGE OF MAILING ADDRESS 2011-03-10 1585 SANTA BARBRA BLVD,, SUITE A, THE VILLAGES, FL 32159 No data
REGISTERED AGENT NAME CHANGED 2009-01-14 UDICK, ARLENE C No data
REGISTERED AGENT ADDRESS CHANGED 2009-01-14 39245 TACOMA DRIVE, LADY LAKE, FL 32159 No data

Documents

Name Date
ANNUAL REPORT 2013-04-22
ANNUAL REPORT 2012-03-31
ANNUAL REPORT 2011-03-10
ANNUAL REPORT 2010-04-19
ANNUAL REPORT 2009-01-14
ANNUAL REPORT 2008-01-29
ANNUAL REPORT 2007-01-16
Domestic Profit 2006-01-25

Related by officers

UDICK, ARLENE C

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DAVIS, JASON E

CASHHQ LLC DIGGA ENTERPRISES LLC JASON E. DAVIS LLC EXCESS INVENTORY LLC BOLD ENTHUSIASM ENTERPRISES INC. JD CONSULTING LLC JAXEBIKE LLC THAT'S GENIUS LLC MD FITNESS & COACHING LLC BAYSHORE SOLUTIONS LLC

DAVIS, DEANNA

JED-DCD LLC DAVIS ALL-BRIGHT HEALTH INSTITUTE INC HEALTH CREDIT, INC. NATIONAL FINANCING, LLC THROTTLE STOP MOTORCYCLE GARAGE, LLC ADVANCED MEDICAL EQUIPMENT, INC EVERY GIRLS SECRET CLOSET LLC ALI DAVIS MENTORING & EDUCATION FOUNDATION INC. PRETTY BUNNY LLC RAD3 ENTERPRISES, CORP

Related by address

No related companies by address

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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