| Entity Name: | SPORTS & SPINE MEDICAL REHABILITATION PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Apr 2015 (10 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 06 May 2019 (6 years ago) |
| Document Number: | L15000073430 |
| FEI/EIN Number | 47-3843059 |
| Address: | 9239 BAYWAY DR, ORLANDO, FL, 32819, US |
| Mail Address: | 9239 BAYWAY DR, ORLANDO, FL, 32819, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134584741 | 2015-12-24 | 2015-12-24 | 9239 BAYWAY DR, ORLANDO, FL, 328194087, US | 9239 BAYWAY DR, ORLANDO, FL, 328194087, US | |||||||||||||
|
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| Phone | +1 310-967-9366 |
Authorized person
| Name | DIANA HUSSAIN |
| Role | PRESIDENT AND FOUNDER |
| Phone | 3109679366 |
Taxonomy
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HUSSAIN DIANA | Agent | 9239 BAYWAY DR, ORLANDO, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| HUSSAIN DIANA | Authorized Member | 9239 BAYWAY DR, ORLANDO, FL, 32819 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2019-05-06 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-05-06 | HUSSAIN, DIANA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-05-06 | 9239 BAYWAY DR, ORLANDO, FL 32819 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-12 |
| ANNUAL REPORT | 2024-01-14 |
| ANNUAL REPORT | 2023-01-05 |
| ANNUAL REPORT | 2022-01-10 |
| ANNUAL REPORT | 2021-01-14 |
| ANNUAL REPORT | 2020-01-11 |
| LC Amendment | 2019-05-06 |
| ANNUAL REPORT | 2019-01-06 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-01-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
