| Entity Name: | VERITY ORTHOPEDICS AND SPINE SURGERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 23 Oct 2006 (18 years ago) |
| Date of dissolution: | 27 Sep 2024 (4 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (4 months ago) |
| Document Number: | L06000103307 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 7300 SANDLAKE COMMONS BLVD., SUITE 220, ORLANDO, FL, 32819 |
| Mail Address: | 7300 SANDLAKE COMMONS BLVD., SUITE 220, ORLANDO, FL, 32819 |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669598538 | 2007-03-22 | 2011-11-30 | 7300 SANDLAKE COMMONS BLVD, SUITE 220, ORLANDO, FL, 328198050, US | 7300 SANDLAKE COMMONS BLVD, STE 220, ORLANDO, FL, 328198050, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 407-248-8000 |
| Fax | 4072488909 |
Authorized person
| Name | JONATHAN D BLACK |
| Role | PRESIDENT |
| Phone | 4072488000 |
Taxonomy
| Taxonomy Code | 207XS0114X - Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | ME92118 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | DG1654 |
| Issuer | MEDICAID |
| Number | 001532900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BLACK JONATHAN D | Agent | 7300 SANDLAKE COMMONS BLVD., ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| BLACK JONATHAN D | Managing Member | 7300 SANDLAKE COMMONS BLVD., SUITE 220, ORLANDO, FL, 32819 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2013-03-05 | BLACK, JONATHAN D | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-02 | 7300 SANDLAKE COMMONS BLVD., SUITE 220, ORLANDO, FL 32819 | No data |
| CHANGE OF MAILING ADDRESS | 2011-03-02 | 7300 SANDLAKE COMMONS BLVD., SUITE 220, ORLANDO, FL 32819 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-03-02 | 7300 SANDLAKE COMMONS BLVD., SUITE 220, ORLANDO, FL 32819 | No data |
| CONVERSION | 2006-10-23 | No data | CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P06000121635. CONVERSION NUMBER 300000060133 |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J21000376925 | TERMINATED | 1000000894786 | ORANGE | 2021-07-19 | 2031-07-28 | $ 595.40 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ORLANDO SERVICE CENTER, 400 W ROBINSON ST STE N302, ORLANDO FL328011759 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-05-24 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-03-12 |
| ANNUAL REPORT | 2019-03-08 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-02-28 |
| ANNUAL REPORT | 2016-03-04 |
| ANNUAL REPORT | 2015-03-07 |
| ANNUAL REPORT | 2014-03-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
