| Entity Name: | BANACKI CHIROPRACTIC SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 May 1996 (29 years ago) |
| Document Number: | P96000043176 |
| FEI/EIN Number | 593378066 |
| Address: | 2429 US ALTERNATE 19 N, PALM HARBOR, FL, 34683, US |
| Mail Address: | 2429 US ALTERNATE 19 N, PALM HARBOR, FL, 34683, US |
| ZIP code: | 34683 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891984001 | 2007-10-24 | 2012-10-31 | 2429 ALT 19, PALM HARBOR, FL, 346832633, US | 2429 ALT 19, PALM HARBOR, FL, 346832633, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 727-786-8991 |
| Fax | 7277841317 |
Authorized person
| Name | DR. JOHN R BANACKI |
| Role | PRESIDENT |
| Phone | 7277868991 |
Taxonomy
| Taxonomy Code | 111NN0400X - Neurology Chiropractor |
| License Number | CH4858 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 050461100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| POGONOWSKI KIM | Agent | 2429 US ALTERNATE 19N, PALM HARBOR, FL, 34683 |
| Name | Role | Address |
|---|---|---|
| POGONOWSKI KIM M | President | 2429 US ALTERNATE 19 N, PALM HARBOR, FL, 34683 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2017-01-05 | POGONOWSKI, KIM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1998-04-02 | 2429 US ALTERNATE 19N, PALM HARBOR, FL 34683 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 1997-04-18 | 2429 US ALTERNATE 19 N, PALM HARBOR, FL 34683 | No data |
| CHANGE OF MAILING ADDRESS | 1997-04-18 | 2429 US ALTERNATE 19 N, PALM HARBOR, FL 34683 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-24 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-03-14 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-02-14 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-01-26 |
| ANNUAL REPORT | 2015-01-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
