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CERTIFIED SPINE AND PAIN CARE, LLC - Florida Company Profile

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Company Details

Entity Name: CERTIFIED SPINE AND PAIN CARE, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 13 Oct 2015 (10 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 17 Oct 2016 (9 years ago)
Document Number: L15000174197
FEI/EIN Number 475514725
Address: 1049 S STATE RD 7, Wellington, FL, 33414, US
Mail Address: 1049 S STATE RD 7, Wellington, FL, 33414, US
ZIP code: 33414
City: Wellington
County: Palm Beach
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
EDWIN MALDONADO WDR Manager 1211 CREKSIDE DR, WELLINGTON, FL, 33414
MALDONADO EDWIN W Agent 1211 CREEKSIDE DR, WELLINGTON, FL, 33414

National Provider Identifier

NPI Number:
1982389417
Certification Date:
2023-06-21

Authorized Person:

Name:
JORGE GARCIA
Role:
CREDENTIALING DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
Yes

Contacts:

Legal Entity Identifier

LEI Number:
549300GSAHVPBGPU4Q65

Registration Details:

Initial Registration Date:
2022-06-24
Next Renewal Date:
2023-06-23
Registration Status:
LAPSED
Validation Source:
FULLY_CORROBORATED

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000021538 CERTIFIED SPINE AND PAIN CARE, LLC EXPIRED 2017-02-28 2022-12-31 - 3345 BURNS ROAD, SUITE 202, PALM BEACH GARDENS, FL, 33410

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2019-06-06 1049 S STATE RD 7, Wellington, FL 33414 -
CHANGE OF MAILING ADDRESS 2019-06-06 1049 S STATE RD 7, Wellington, FL 33414 -
REINSTATEMENT 2016-10-17 - -
REGISTERED AGENT NAME CHANGED 2016-10-17 MALDONADO, EDWIN W -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2016-09-23 - -

Documents

Name Date
ANNUAL REPORT 2025-02-05
ANNUAL REPORT 2024-03-04
ANNUAL REPORT 2023-01-24
ANNUAL REPORT 2022-01-21
ANNUAL REPORT 2021-07-26
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-04-30
ANNUAL REPORT 2018-04-01
ANNUAL REPORT 2017-03-15
REINSTATEMENT 2016-10-17

USAspending Awards / Financial Assistance

Date:
2021-03-12
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
122223.00
Total Face Value Of Loan:
122223.00
Date:
2020-04-13
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
93500.00
Total Face Value Of Loan:
93500.00
Date:
2020-04-13
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
93500.00
Total Face Value Of Loan:
93500.00

Paycheck Protection Program

Jobs Reported:
19
Initial Approval Amount:
$122,223
Date Approved:
2021-03-12
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$122,223
Race:
Unanswered
Ethnicity:
Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$123,122.7
Servicing Lender:
Transportation Alliance Bank, Inc. d/b/a TAB Bank
Use of Proceeds:
Payroll: $122,223
Jobs Reported:
26
Initial Approval Amount:
$93,500
Date Approved:
2020-04-12
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$93,500
Race:
Unanswered
Ethnicity:
Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$94,606.42
Servicing Lender:
SouthState Bank, National Association
Use of Proceeds:
Payroll: $93,500

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Date of last update: 03 Aug 2025

Sources: Florida Department of State