| Entity Name: | NEUROLOGY & SPINE DISORDERS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Feb 2010 (15 years ago) |
| Date of dissolution: | 06 Mar 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 06 Mar 2015 (10 years ago) |
| Document Number: | L10000019810 |
| FEI/EIN Number | 27-1985236 |
| Address: | 1673 MASON AVENUE, SUITE 305, DAYTONA BEACH, FL, 32117 |
| Mail Address: | PO BOX 48, DAYTONA BEACH, FL, 32115 |
| ZIP code: | 32117 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790008811 | 2010-03-03 | 2010-09-08 | 1673 MASON AVE, SUITE 107, DAYTONA BEACH, FL, 321175515, US | 5111 S RIDGEWOOD AVE, SUITE 102, PORT ORANGE, FL, 321275169, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 386-274-7118 |
| Fax | 3862746173 |
| Phone | +1 386-763-4484 |
| Fax | 3867631288 |
Authorized person
| Name | MR. AL FALCO |
| Role | CEO |
| Phone | 3862747118 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | ME46005 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 000EZ |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DQ2689 |
| State | FL |
| Name | Role |
|---|---|
| R&A AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| STONE MELVIN | Manager | PO BOX 48, DAYTONA BEACH, FL, 32115 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-03-06 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-23 | 1673 MASON AVENUE, SUITE 305, DAYTONA BEACH, FL 32117 | No data |
| LC NAME CHANGE | 2010-07-30 | NEUROLOGY & SPINE DISORDERS, LLC | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-03-06 |
| ANNUAL REPORT | 2014-01-22 |
| ANNUAL REPORT | 2013-04-12 |
| ANNUAL REPORT | 2012-04-23 |
| ANNUAL REPORT | 2011-03-30 |
| LC Name Change | 2010-07-30 |
| Florida Limited Liability | 2010-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
