| Entity Name: | BACK-2-LIFE OF FLORIDA, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 02 Jan 2007 (18 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P07000000590 |
| FEI/EIN Number | 208136637 |
| Address: | 3001 EASTLAND BLVD, SUITE 2, CLEARWATER, FL, 33761 |
| Mail Address: | 3001 EASTLAND BLVD, SUITE 2, CLEARWATER, FL, 33761 |
| ZIP code: | 33761 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831360361 | 2008-03-12 | 2008-03-12 | 2905 RIGSBY LN, SAFETY HARBOR, FL, 346954828, US | 8250 BRYAN DAIRY RD, SUITE#310, LARGO, FL, 337771353, US | |||||||||||||||||||||||
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| Phone | +1 727-797-0500 |
| Fax | 7277970057 |
| Fax | 7277970050 |
Authorized person
| Name | DR. ERIC K GROTEKE |
| Role | PARTNER |
| Phone | 7277970500 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 71494 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GROTEKE ERIC K | Agent | 3001 EASTLAND BLVD., CLEARWATER, FL, 33761 |
| Name | Role | Address |
|---|---|---|
| GROTEKE DR. ERIC K | President | 3001 EASTLAND BLVD, CLEARWATER, FL, 33761 |
| Name | Role | Address |
|---|---|---|
| STAFFORD DAMON J | Vice President | 3001 EASTLAND BLVD, CLEARWATER, FL, 33761 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-30 | 3001 EASTLAND BLVD., SUITE 2, CLEARWATER, FL 33761 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2009-04-30 | 3001 EASTLAND BLVD, SUITE 2, CLEARWATER, FL 33761 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-30 | 3001 EASTLAND BLVD, SUITE 2, CLEARWATER, FL 33761 | No data |
| CANCEL ADM DISS/REV | 2008-10-28 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-08-07 | GROTEKE, ERIC KD.C. | No data |
| AMENDMENT | 2007-08-07 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-04-30 |
| REINSTATEMENT | 2008-10-28 |
| Amendment | 2007-08-07 |
| Domestic Profit | 2007-01-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
