| Entity Name: | INDIAN ROCKS FAMILY CHIROPRACTIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 11 Jan 1993 (32 years ago) |
| Document Number: | P93000002876 |
| FEI/EIN Number | 593361088 |
| Address: | 13002 SEMINOLE BLVD #4, LARGO, FL, 33778, US |
| Mail Address: | 13002 SEMINOLE BLVD #4, LARGO, FL, 33778, US |
| ZIP code: | 33778 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568822542 | 2016-03-03 | 2016-03-03 | 13002 SEMINOLE BLVD, #4, LARGO, FL, 337782125, US | 13002 SEMINOLE BLVD, #4, LARGO, FL, 337782125, US | |||||||||||||||||||||||
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| Phone | +1 727-585-8888 |
Authorized person
| Name | DR. MARK CARLO |
| Role | PRESIDENT/OWNER |
| Phone | 7275858888 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH6715 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 381074700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARLO MARK | Agent | 6980 ULMERTON RD 6E, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| CARLO MARK G | President | 6980 ULMERTON RD 6E, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| CARLO MARK G | Treasurer | 6980 ULMERTON RD 6E, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| CARLO MARK G | Director | 6980 ULMERTON RD 6E, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| CARLO JANA G | Vice President | 6980 ULMERTON RD 6E, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| CARLO JANA G | Secretary | 6980 ULMERTON RD 6E, LARGO, FL, 33771 |
| Name | Role | Address |
|---|---|---|
| Hernstrom Damion | Officer | 13002 SEMINOLE BLVD #4, LARGO, FL, 33778 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000054550 | DR MARK CARLO DC | EXPIRED | 2019-05-03 | 2024-12-31 | No data | 13002 SEMINOLE BLVD, #4, LARGO, FL, 33778 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001082057 | LAPSED | 2010-0036939-CI | 6TH JUD CIR, PINELLAS | 2013-05-22 | 2018-06-12 | $250,027.82 | REGIONS BANK, 20901 SW 112TH AVENUE, MIAMI, FL 33189 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
