| Entity Name: | PREMIER HEALTH ORMOND, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Dec 2011 (13 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P11000108373 |
| Address: | 325 CLYDE MORRIS BLVD., SUITE 390, ORMOND BEACH, FL, 32174 |
| Mail Address: | 325 CLYDE MORRIS BLVD., SUITE 390, ORMOND BEACH, FL, 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922370246 | 2012-02-01 | 2012-02-24 | 325 CLYDE MORRIS BLVD, SUITE #390, ORMOND BEACH, FL, 321748178, US | 325 CLYDE MORRIS BLVD, SUITE #390, ORMOND BEACH, FL, 321748178, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 386-872-3600 |
| Fax | 3866159137 |
Authorized person
| Name | DR. CHRISTOPHER BURNHAM |
| Role | CHIROPRACTIC SERVICES DIRECTOR |
| Phone | 3868723600 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10080 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 057503 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BURNHAM CHRISTOPHER R | Agent | 325 CLYDE MORRIS BLVD., ORMOND BEACH, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| BURNHAM CHRISTOPHER R | Director | 325 CLYDE MORRIS BLVD., ORMOND BEACH, FL, 32174 |
| COLEMAN HUGH A | Director | 325 CLYDE MORRIS BLVD, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2011-12-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
