| Entity Name: | BROWARD SPINE INSTITUTE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Oct 2003 (21 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 09 Oct 2006 (18 years ago) |
| Document Number: | L03000037846 |
| FEI/EIN Number | 200279912 |
| Address: | 3702 WASHINGTON STREET, SUITE 101, HOLLYWOOD, FL, 33021, US |
| Mail Address: | 3702 WASHINGTON STREET, SUITE 101, HOLLYWOOD, FL, 33021, US |
| ZIP code: | 33021 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821219155 | 2007-05-02 | 2015-05-18 | 3702 WASHINGTON ST, STE 101, HOLLYWOOD, FL, 330218282, US | 3702 WASHINGTON ST, STE 101, HOLLYWOOD, FL, 330218282, US | |||||||||||||||||||||||||||
|
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| Phone | +1 954-272-2225 |
| Fax | 9542720554 |
Authorized person
| Name | MARSHALL STAUBER |
| Role | OWNER |
| Phone | 9542722225 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| Is Primary | No |
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 207XS0117X - Orthopaedic Surgery of the Spine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| STAUBER MARSHALL E | Agent | 3702 WASHINGTON STREET, HOLLYWOOD, FL, 33021 |
| Name | Role | Address |
|---|---|---|
| STAUBER MARSHALL E | Managing Member | 3702 WASHINGTON STREET, HOLLYWOOD, FL, 33021 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2008-01-14 | STAUBER, MARSHALL E | No data |
| CANCEL ADM DISS/REV | 2006-10-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-01-07 | 3702 WASHINGTON STREET, SUITE 101, HOLLYWOOD, FL 33021 | No data |
| CHANGE OF MAILING ADDRESS | 2005-01-07 | 3702 WASHINGTON STREET, SUITE 101, HOLLYWOOD, FL 33021 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-01-07 | 3702 WASHINGTON STREET, SUITE 101, HOLLYWOOD, FL 33021 | No data |
| NAME CHANGE AMENDMENT | 2004-03-18 | BROWARD SPINE INSTITUTE, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-02 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-05-05 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-02-27 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-02-01 |
| ANNUAL REPORT | 2016-02-16 |
| ANNUAL REPORT | 2015-01-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
