| Entity Name: | SPINE SPECIALISTS OF AMERICA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Sep 2013 (11 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | L13000135801 |
| Address: | 13035 W LINEBAUGH AVE, BUILDING #101, SUITE F, TAMPA, FL, 33626 |
| Mail Address: | 13035 W LINEBAUGH AVE, BUILDING #101, SUITE F, TAMPA, FL, 33626 |
| ZIP code: | 33626 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881022903 | 2013-10-29 | 2013-10-29 | 13035 W LINEBAUGH AVE STE 101F, TAMPA, FL, 336264481, US | 13035 W LINEBAUGH AVE STE 101F, TAMPA, FL, 336264481, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 727-474-9729 |
| Fax | 7274749947 |
Authorized person
| Name | ERIC K GROTEKE |
| Role | MEMBER |
| Phone | 7274749729 |
Taxonomy
| Taxonomy Code | 207XS0117X - Orthopaedic Surgery of the Spine Physician |
| License Number | ME54499 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME85743 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME115987 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GROTEKE ERIC K | Agent | 13035 W. LINEBAUGH AVE, TAMPA, FL, 33626 |
| Name | Role |
|---|---|
| ERIC K GROTEKE, DC, PLLC | Manager |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000102324 | SPINE SPECIALISTS NETWORK | EXPIRED | 2013-10-16 | 2018-12-31 | No data | 13035 W. LINEBAUGH AVE, #101, SUITE F, TAMPA, FL, 33626 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| LC DISSOCIATION MEM | 2014-01-22 | No data | No data |
| Name | Date |
|---|---|
| CORLCDSMEM | 2014-01-22 |
| Florida Limited Liability | 2013-09-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
