| Entity Name: | ELITE SPINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
ELITE SPINE LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 07 Jan 2016 (9 years ago) |
| Document Number: | L16000005612 |
| FEI/EIN Number |
81-0978310
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 800 DUNLAWTON AVE., PORT ORANGE, FL, 32127, US |
| Mail Address: | 800 DUNLAWTON AVE., PORT ORANGE, FL, 32127, US |
| ZIP code: | 32127 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639698269 | 2017-09-14 | 2021-10-04 | 800 DUNLAWTON AVE STE 103, PORT ORANGE, FL, 321274249, US | 800 DUNLAWTON AVE STE 103, PORT ORANGE, FL, 321274249, US | |||||||||||||||||||||||||
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| Phone | +1 386-265-0102 |
| Fax | 3864012316 |
Authorized person
| Name | RACHEL NAKAYAMA |
| Role | OWNER |
| Phone | 3868722929 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| License Number | CH12049 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1295271344 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NAKAYAMA RACHEL | Manager | 800 DUNLAWTON AVE., PORT ORANGE, FL, 32127 |
| Nakayama Rachel | Agent | 800 DUNLAWTON AVE., PORT ORANGE, FL, 32127 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2022-01-22 | Nakayama, Rachel | - |
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-11 | 800 DUNLAWTON AVE., 103, PORT ORANGE, FL 32127 | - |
| CHANGE OF MAILING ADDRESS | 2020-02-11 | 800 DUNLAWTON AVE., 103, PORT ORANGE, FL 32127 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-11 | 800 DUNLAWTON AVE., 103, PORT ORANGE, FL 32127 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-05 |
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-02-02 |
| ANNUAL REPORT | 2022-01-22 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-03-09 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-01-18 |
| Florida Limited Liability | 2016-01-07 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2968478602 | 2021-03-16 | 0491 | PPS | 5524 Estero Loop, Port Orange, FL, 32128-0006 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3345117808 | 2020-05-26 | 0491 | PPP | 800 DUNLAWTON AVENUE UNIT 103, PORT ORANGE, FL, 32127-4248 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Mar 2025
Sources: Florida Department of State
