| Entity Name: | INTEGRATIVE CHIROPRACTIC & PHYSICAL THERAPY SOLUTIONS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 04 Sep 2008 (16 years ago) |
| Date of dissolution: | 24 Mar 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 24 Mar 2021 (4 years ago) |
| Document Number: | P08000087085 |
| FEI/EIN Number | 90-0416733 |
| Address: | 4657 GULF BREEZE PARKWAY A & B, UNITS A & B, GULF BREEZE, FL 32563 |
| Mail Address: | 4657 GULF BREEZE PARKWAY A & B, UNITS A & B, GULF BREEZE, FL 32563 |
| ZIP code: | 32563 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811167869 | 2008-03-06 | 2012-06-21 | 4657 GULF BREEZE PKWY STE A&B, GULF BREEZE, FL, 325639166, US | 4657 GULF BREEZE PKWY STE A&B, GULF BREEZE, FL, 325639166, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-916-9304 |
| Fax | 8509169306 |
Authorized person
| Name | DR. KAREN A CANN |
| Role | OWNER |
| Phone | 8509169304 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH8649 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 225100000X - Physical Therapist |
| License Number | PT 20841 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 8924112 |
| State | FL |
| Issuer | MEDICAID |
| Number | 3821684 |
| State | FL |
| Issuer | AETNA |
| Number | 7324727 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CANN, KAREN | Agent | 2 Portofino Drive, Ste 805, GULF BREEZE, FL 32561 |
| Name | Role | Address |
|---|---|---|
| CANN, KAREN | President | 4657 GULF BREEZE PARKWAY A & B, GULF BREEZE, FL 32563 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-03-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-06-18 | 2 Portofino Drive, Ste 805, GULF BREEZE, FL 32561 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-04-06 | 4657 GULF BREEZE PARKWAY A & B, UNITS A & B, GULF BREEZE, FL 32563 | No data |
| CHANGE OF MAILING ADDRESS | 2010-04-06 | 4657 GULF BREEZE PARKWAY A & B, UNITS A & B, GULF BREEZE, FL 32563 | No data |
| CONVERSION | 2008-09-22 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS L05000037659. CONVERSION NUMBER 900000090349 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-03-24 |
| ANNUAL REPORT | 2020-04-03 |
| ANNUAL REPORT | 2019-06-18 |
| ANNUAL REPORT | 2018-03-17 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-01-16 |
| ANNUAL REPORT | 2013-04-16 |
| ANNUAL REPORT | 2012-04-13 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
