| Entity Name: | RUSSELL CHIROPRACTIC & WELLNESS CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Mar 1997 (28 years ago) |
| Document Number: | P97000023038 |
| FEI/EIN Number | 593432755 |
| Address: | 2800 West Gulf to Lake Hwy, N/A, Lecanto, FL, 34461, US |
| Mail Address: | 741 N. Country Club Dr., N/A, Crystal River, FL, 34429, US |
| ZIP code: | 34461 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477888014 | 2009-10-15 | 2021-03-12 | 741 N. COUNTRY CLUB DR., CRYSTAL, FL, 344295405, US | 2800 W. GULF TO LAKE HWY., LECANTO, FL, 344619205, US | |||||||||||||||||||||||||||||||
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| Phone | +1 352-726-0888 |
| Fax | 3527265504 |
Authorized person
| Name | DR. RUSSELL J LEWANDOWSKI |
| Role | PRESIDENT |
| Phone | 3527260888 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH 6678 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 382206100 |
| State | FL |
| Issuer | NPI- RUSSELL LEWANDOWSKI D.C. |
| Number | 1295717072 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEWANDOWSKI RUSSELL J | Agent | 741 N. Country Club Dr., Crystal River, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| LEWANDOWSKI RUSSELL J | President | 741 N. COUNTRY CLUB DRIVE, CRYSTAL RIVER, FL, 34429 |
| LEWANDOWSKI VICKIE C | President | 741 N. COUNTRY CLUB DR., CRYSTAL RIVER, FL, 34429 |
| Name | Role | Address |
|---|---|---|
| LEWANDOWSKI VICKIE C | Vice President | 741 N. COUNTRY CLUB DR., CRYSTAL RIVER, FL, 34429 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-26 | 2800 West Gulf to Lake Hwy, N/A, Lecanto, FL 34461 | No data |
| CHANGE OF MAILING ADDRESS | 2014-04-29 | 2800 West Gulf to Lake Hwy, N/A, Lecanto, FL 34461 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-04-29 | 741 N. Country Club Dr., Crystal River, FL 34429 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-03-30 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-28 |
| ANNUAL REPORT | 2018-02-19 |
| ANNUAL REPORT | 2017-02-17 |
| ANNUAL REPORT | 2016-03-18 |
| ANNUAL REPORT | 2015-03-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
