| Entity Name: | SPINE AND ORTHOPAEDIC SPECIALISTS, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Feb 2006 (19 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 14 Nov 2008 (16 years ago) |
| Document Number: | L06000013942 |
| FEI/EIN Number | 204199089 |
| Address: | 2040 SHORT AVE., ODESSA, FL, 33556 |
| Mail Address: | 2040 SHORT AVE., ODESSA, FL, 33556 |
| ZIP code: | 33556 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487743563 | 2006-10-12 | 2010-04-27 | 2040 SHORT AVE, ODESSA, FL, 335563427, US | 2040 SHORT AVE, ODESSA, FL, 335563427, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-372-9922 |
| Fax | 7273728477 |
Authorized person
| Name | FARHAN NAVEED SIDDIQI |
| Role | PARTNER |
| Phone | 7273729922 |
Taxonomy
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | ME96330 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 207X00000X - Orthopaedic Surgery Physician |
| License Number | ME96135 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 207XS0117X - Orthopaedic Surgery of the Spine Physician |
| License Number | ME96135 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PRESIDENT MEDICAL LICENSE |
| Number | ME96330 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SIDDIQI FARHAN M | Agent | 2040 SHORT AVE., ODESSA, FL, 33556 |
| Name | Role | Address |
|---|---|---|
| SIDDIQI FARHAN | Managing Member | 10300 ALTRARA WAY, TRINITY, FL, 34655 |
| HAYES VICTOR | Managing Member | 2148 GOLD DUST CT., TRINITY, FL, 34655 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000038323 | TRINTY SPINE CENTER | EXPIRED | 2017-04-11 | 2022-12-31 | No data | 2040 SHORT AVE, ODESSA, FL, 33556 |
| G11000069312 | TRINITY SPINE CENTER | EXPIRED | 2011-07-11 | 2016-12-31 | No data | 2040 SHORT AVENUE, ODESSA, FL, 33556 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2008-11-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2008-11-14 | SIDDIQI, FARHAN MD | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-11-14 | 2040 SHORT AVE., ODESSA, FL 33556 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-11-03 | 2040 SHORT AVE., ODESSA, FL 33556 | No data |
| CHANGE OF MAILING ADDRESS | 2008-11-03 | 2040 SHORT AVE., ODESSA, FL 33556 | No data |
| CANCEL ADM DISS/REV | 2007-10-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| LC NAME CHANGE | 2006-08-22 | SPINE AND ORTHOPAEDIC SPECIALISTS, PLLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-13 |
| ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2022-03-13 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-03-21 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-02-14 |
| ANNUAL REPORT | 2017-03-14 |
| ANNUAL REPORT | 2016-01-25 |
| ANNUAL REPORT | 2015-01-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
