| Entity Name: | NOVUS SPINE, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 08 Aug 2016 (8 years ago) |
| Document Number: | L16000147334 |
| FEI/EIN Number | 81-4914584 |
| Mail Address: | 1106 LINFORD CT, VALRICO, FL 33596 |
| Address: | 631 MID-FLORIDA DR, LAKELAND, FL 33813 |
| ZIP code: | 33813 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407300890 | 2016-08-15 | 2020-11-13 | 631 MID FLORIDA DRIVE, LAKELAND, FL, 338134902, US | 631 MID-FLORIDA DRIVE, LAKELAND, FL, 338134902, US | |||||||||||||||||||||||
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| Phone | +1 863-583-4445 |
| Fax | 8632255289 |
Authorized person
| Name | DR. BENITO TORRES |
| Role | OWNER |
| Phone | 8635834445 |
Taxonomy
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | OS10656 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NOVUS SPINE 401(K) PROFIT SHARING PLAN | 2023 | 814914584 | 2024-08-01 | NOVUS SPINE, LLC | 3 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-08-01 |
| Name of individual signing | BENITO TORRES |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| TORRES, BENITO M, DO | Agent | 1106 LINFORD CT, VALRICO, FL 33596 |
| Name | Role | Address |
|---|---|---|
| TORRES, BENITO M, DO | Authorized Member | 1106 LINFORD CT, VALRICO, FL 33596 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-10 | 631 MID-FLORIDA DR, LAKELAND, FL 33813 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-25 |
| ANNUAL REPORT | 2023-01-04 |
| ANNUAL REPORT | 2022-01-06 |
| ANNUAL REPORT | 2021-01-11 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-01-09 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-23 |
| Florida Limited Liability | 2016-08-08 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
