| Entity Name: | DEBARY CHIROPRACTIC CENTER CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Jun 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Jan 2022 (3 years ago) |
| Document Number: | P17000051158 |
| FEI/EIN Number | 82-1784483 |
| Address: | 70 Fox Ridge Ct, Suite A, Debary, FL, 32713, US |
| Mail Address: | 70 Fox Ridge Ct, Suite A, Debary, FL, 32713, US |
| ZIP code: | 32713 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255853461 | 2017-07-10 | 2021-01-20 | 70 FOX RIDGE CT STE A, DEBARY, FL, 327132752, US | 70 FOX RIDGE CT STE A, DEBARY, FL, 327132752, US | |||||||||||||||||||||||
|
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| Phone | +1 386-668-6321 |
Authorized person
| Name | JAMIE GRAINGER |
| Role | OWNER |
| Phone | 3866686321 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH12148 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UHC OPTUM |
| Number | 058586 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GRAINGER DC JAMIE | Agent | 70 Fox Ridge Ct, Debary, FL, 32713 |
| Name | Role | Address |
|---|---|---|
| GRAINGER DC JAMIE | President | 70 Fox Ridge Ct, Debary, FL, 32713 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000077169 | ULTIMATE SPINE AND WELLNESS | EXPIRED | 2019-07-17 | 2024-12-31 | No data | 1251 S VOLUSIA AVE, ORANGE CITY, FL, 32763 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-01-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-07 | GRAINGER DC, JAMIE | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-02 | 70 Fox Ridge Ct, Suite A, Debary, FL 32713 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-02 | 70 Fox Ridge Ct, Suite A, Debary, FL 32713 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-02 | 70 Fox Ridge Ct, Suite A, Debary, FL 32713 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-01-18 |
| REINSTATEMENT | 2022-01-07 |
| ANNUAL REPORT | 2020-06-02 |
| ANNUAL REPORT | 2019-04-24 |
| ANNUAL REPORT | 2018-05-01 |
| Domestic Profit | 2017-06-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
