| Entity Name: | CHANGES FAMILY PRACTICE CLINIC INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 06 Jul 2015 (10 years ago) |
| Date of dissolution: | 24 Sep 2021 (3 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2021 (3 years ago) |
| Document Number: | P15000058023 |
| FEI/EIN Number | 47-4446127 |
| Address: | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 |
| Mail Address: | 1565 W 36TH STREET, RIVIERA BEACH, FL 33404 |
| ZIP code: | 33404 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316320591 | 2015-07-07 | 2015-07-07 | 1531 W 12TH ST, RIVIERA BEACH, FL, 334046512, US | 31 W 20TH ST, RIVIERA BEACH, FL, 334046155, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 561-899-9140 |
| Fax | 5613312715 |
Authorized person
| Name | ANGELA D ENGRAM |
| Role | PRESIDENT |
| Phone | 5618999140 |
Taxonomy
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ENGRAM, ANGELA D | Agent | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 |
| Name | Role | Address |
|---|---|---|
| ENGRAM, ANGELA D | President | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 |
| Name | Role | Address |
|---|---|---|
| ENGRAM, SHARON | Vice President | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-29 | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-29 | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-29 | 1565 WEST 36TH STREET, RIVIERA BEACH, FL 33404 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-29 |
| Domestic Profit | 2015-07-06 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
