| Entity Name: | NORTHWEST BROWARD NEUROSURGERY AND SPINE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 10 Apr 2007 (18 years ago) |
| Date of dissolution: | 30 Dec 2010 (14 years ago) |
| Last Event: | LC VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Dec 2010 (14 years ago) |
| Document Number: | L07000038527 |
| FEI/EIN Number | 61-1526854 |
| Address: | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Mail Address: | ONE PARK PLAZA - LEGAL DEPT., NASHVILLE, TN 37203 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699966440 | 2007-08-07 | 2007-08-29 | 5901 COLONIAL DR, SUITE 311, MARGATE, FL, 330635675, US | 5901 COLONIAL DR, SUITE 311, MARGATE, FL, 330635675, US | |||||||||||||||||||
|
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| Phone | +1 954-973-4840 |
Authorized person
| Name | MR. GARY DUNCAN |
| Role | VP |
| Phone | 5615483878 |
Taxonomy
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PENDING |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| MOORE, A. BRUCE JR. | Manager | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| JOHNSON, R. MILTON | Manager | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| RUTHERFORD, WILLIAM B | Manager | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC VOLUNTARY DISSOLUTION | 2010-12-30 | No data | No data |
| Name | Date |
|---|---|
| LC Voluntary Dissolution | 2010-12-30 |
| ANNUAL REPORT | 2010-04-26 |
| ANNUAL REPORT | 2009-03-31 |
| ANNUAL REPORT | 2008-04-24 |
| Florida Limited Liability | 2007-04-10 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State
