| Entity Name: | INTERVENTIONAL SPINE CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 16 Jan 2013 (12 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L13000008125 |
| FEI/EIN Number | NOT APPLICABLE |
| Address: | 150 SW 12TH AVE, 101, POMPANO BEACH, AL, 33069, US |
| Mail Address: | 150 SW 12TH AVE, 101, POMPANO BEACH, AL, 33069, US |
| ZIP code: | 33069 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366780496 | 2013-01-24 | 2013-01-24 | 150 SW 12TH AVE, SUITE 101, POMPANO BEACH, FL, 330693298, US | 150 SW 12TH AVE, SUITE 101, POMPANO BEACH, FL, 330693298, US | |||||||||||||||||
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| Phone | +1 561-543-8888 |
Authorized person
| Name | RAHAT FADERANI |
| Role | DOCTOR |
| Phone | 5615438888 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | OS10474 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Topkin Sanford R | Agent | 1166 W NEWPORT CENTER DR SUITE 309, DEERFIELD BEACH, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| STAMATAKOS DIMITRIOS | Manager | 5645 CORAL RIDGE DRIVE, SUITE 222, CORAL SPRINGS, FL, 33076 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-07-10 | Topkin, Sanford R. | No data |
| REINSTATEMENT | 2017-07-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| LC AMENDMENT | 2014-09-29 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-09-29 | 1166 W NEWPORT CENTER DR SUITE 309, DEERFIELD BEACH, FL 33442 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-06-10 | 150 SW 12TH AVE, 101, POMPANO BEACH, AL 33069 | No data |
| CHANGE OF MAILING ADDRESS | 2014-06-10 | 150 SW 12TH AVE, 101, POMPANO BEACH, AL 33069 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2017-07-10 |
| ANNUAL REPORT | 2015-01-08 |
| LC Amendment | 2014-09-29 |
| ANNUAL REPORT | 2014-06-10 |
| Florida Limited Liability | 2013-01-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
