| Entity Name: | VITAL WELLNESS CHIROPRACTIC, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 08 Feb 2021 (4 years ago) |
| Document Number: | P21000014149 |
| FEI/EIN Number | 86-2125434 |
| Address: | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 |
| Mail Address: | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609442284 | 2021-06-03 | 2021-06-03 | 931 SW ROMAINE LN, PORT ST LUCIE, FL, 349533605, US | 3543 SW CORPORATE PKWY, PALM CITY, FL, 349908151, US | |||||||||||||||||||||
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| Phone | +1 248-207-0176 |
| Phone | +1 772-232-4091 |
Authorized person
| Name | DR. BRANDON LEVENICK |
| Role | CHIROPRACTIC PHYSICIAN |
| Phone | 2482070176 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA DEPARTMENT OF HEALTH |
| Number | 1013456359 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEVENICK, BRANDON | Agent | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 |
| Name | Role | Address |
|---|---|---|
| LEVENICK, BRANDON | President | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000072324 | VITAL WELLNESS CENTER | ACTIVE | 2021-05-28 | 2026-12-31 | No data | 931 SW ROMAINE LANE, PORT ST. LUCIE, FL, 34953 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-03-12 | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-03-12 | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-06-14 | 434 NW LAKE WHITNEY PLACE, port st lucie, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-10 |
| Domestic Profit | 2021-02-08 |
Date of last update: 14 Jan 2025
Sources: Florida Department of State
