| Entity Name: | LAKE WORTH PHYSICAL MEDICINE INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 May 2012 (13 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 01 Mar 2017 (8 years ago) |
| Document Number: | P12000040959 |
| FEI/EIN Number | 45-5200597 |
| Address: | 3044 SOUTH MILITARY TRAIL,, LAKE WORTH, FL, 33463, US |
| Mail Address: | P.O. BOX 16836, WEST PALM BEACH, FL, 33416, US |
| ZIP code: | 33463 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043579618 | 2012-05-16 | 2016-11-02 | PO BOX 16836, WEST PALM BEACH, FL, 334166836, US | 1722-A SOUTH CONGRESS AVE, PALM SPRINGS, FL, 33461, US | |||||||||||||||||||
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| Phone | +1 561-868-5668 |
| Fax | 5618685702 |
Authorized person
| Name | DR. JONATHAN GRAND |
| Role | PRESIDENT |
| Phone | 5617297089 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH9392 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SANFORD R TOPKIN ESQ | Agent | 1166 W NEWPORT CENTER DR #309, DEERFIELD BEACH, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| GRAND JESSE | President | P.O. BOX 16836, WEST PALM BEACH, FL, 33416 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000041984 | PALM BEACH PHYSICAL MEDICINE | ACTIVE | 2012-05-03 | 2027-12-31 | No data | 3044-D SOUTH MILITARY TRAIL, LAKE WORTH, FL, 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2017-11-28 | 3044 SOUTH MILITARY TRAIL,, SUITE D, LAKE WORTH, FL 33463 | No data |
| AMENDMENT | 2017-03-01 | No data | No data |
| AMENDMENT | 2016-12-12 | No data | No data |
| AMENDMENT | 2016-11-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-11-02 | SANFORD R TOPKIN ESQ | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-11-02 | 1166 W NEWPORT CENTER DR #309, DEERFIELD BEACH, FL 33442 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-01 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-19 |
| ANNUAL REPORT | 2020-04-23 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-03-02 |
| ANNUAL REPORT | 2017-04-03 |
| Amendment | 2017-03-01 |
| Amendment | 2016-12-12 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
