| Entity Name: | FLORIDA SPINE AND PAIN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Feb 2016 (9 years ago) |
| Document Number: | L16000034231 |
| FEI/EIN Number | 81-3270244 |
| Address: | 3234 SW 105th St., Gainesville, FL, 32608, US |
| Mail Address: | 3234 SW 105th St., Gainesville, FL, 32608, US |
| ZIP code: | 32608 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801346184 | 2016-10-10 | 2017-03-04 | 1400 N US HWY 441, STE 536, LADY LAKE, FL, 321598986, US | 1400 N US HWY 441, STE 536, LADY LAKE, FL, 321598986, US | |||||||||||||||||||
|
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| Phone | +1 352-775-2826 |
| Fax | 3525474011 |
Authorized person
| Name | VIJAY GUTTI BABU |
| Role | CEO |
| Phone | 3527752826 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | ME126127 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BABU VIJAY | Agent | 3234 SW 105th St., Gainesville, FL, 32608 |
| Name | Role | Address |
|---|---|---|
| BABU VIJAY | Manager | 3234 SW 105th St., Gainesville, FL, 32608 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-23 | 3234 SW 105th St., Gainesville, FL 32608 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-23 | 3234 SW 105th St., Gainesville, FL 32608 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-23 | 3234 SW 105th St., Gainesville, FL 32608 | No data |
| REGISTERED AGENT NAME CHANGED | 2017-01-26 | BABU, VIJAY | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-04-03 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-04-26 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-01-26 |
| Florida Limited Liability | 2016-02-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
