{"entity":{"id":9265352,"state":"FL","state_id":"P23000074033","entity_name":"THE CENTER FOR FUNCTIONAL, AESTHETIC AND ANTI AGING MEDICINE INC.","entity_type":"DOMP","entity_type_normalized":"domestic_profit","status":"A","filing_date":"2023-10-17","filing_year":2023,"business_age_years":3,"principal_address1":"571 AVENUE K SE","principal_address2":"","principal_city":"WINTER HAVEN","principal_state":"FL","principal_zip":"33880","principal_country":"US","mail_address1":"571 AVENUE K SE","mail_address2":"","mail_city":"DAVENPORT","mail_state":"FL","mail_zip":"33837","mail_country":"US","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"93-3966826","jurisdiction":null,"county":null,"last_transaction_date":"10302024","report_year_1":"2025","report_date_1":"05022025","report_year_2":"2025","report_date_2":"05022025","report_year_3":"2024","report_date_3":"05012024","agent_name":"Registered Agent LLC Republic","agent_type":"C","agent_address":"476 RIVERSIDE AVE,","agent_city":"JACKSONVILLE","agent_state":"FL","agent_zip":"32202","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata3.txt","fetched_at":"2026-05-09 11:26:01","updated_at":"2026-05-09 11:26:01","last_accessed":null,"status_reason":null,"agent_name_raw":"REPUBLIC REGISTERED AGENT LLC"},"officers":[{"name":"Danice Blaise","first_name":"Danice","last_name":"Blaise","title":"Director","title_roles":["Director"],"title_code":"dire","is_registered_agent":false,"address":"571 AVENUE K SE","city":"WINTER HAVEN","state":"FL","zip":"33880","name_raw":"BLAISE              DANICE"},{"name":"Danice Blaise","first_name":"Danice","last_name":"Blaise","title":"President","title_roles":["President"],"title_code":"pres","is_registered_agent":false,"address":"4075 LAKE NED VILLAGE CIRCLE","city":"WINTER HAVEN","state":"FL","zip":"33884","name_raw":"BLAISE              DANICE"}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/P23000074033"}