| Entity Name: | ORANGE PARK SPINE INSTITUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Jan 2017 (8 years ago) |
| Document Number: | L17000015665 |
| FEI/EIN Number | 81-4262541 |
| Address: | 1409 KINGSLEY AVENUE, SUITE 9F, ORANGE PARK, FL, 32073, US |
| Mail Address: | 1409 KINGSLEY AVENUE, SUITE 9F, ORANGE PARK, FL, 32073, US |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1366989246 | 2017-01-30 | 2017-01-30 | 1409 KINGSLEY AVE, SUITE 1D, ORANGE PARK, FL, 320734537, US | 1409 KINGSLEY AVE, SUITE 1D, ORANGE PARK, FL, 320734537, US | |||||||||||||||||||
|
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| Phone | +1 904-504-7767 |
| Fax | 9043751761 |
Authorized person
| Name | DR. CONSTANTINE ANDREW TOUMBIS |
| Role | PRESIDENT/SURGEON |
| Phone | 3522573391 |
Taxonomy
| Taxonomy Code | 207XS0117X - Orthopaedic Surgery of the Spine Physician |
| License Number | ME80012 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TOUMBIS CONSTANTINE A | Agent | 1409 KINGSLEY AVENUE, ORANGE PARK, FL, 32073 |
| Name | Role | Address |
|---|---|---|
| TOUMBIS CONSTANTINE A | Manager | 1409 KINGSLEY AVENUE, ORANGE PARK, FL, 32073 |
| Name | Role | Address |
|---|---|---|
| TOUMBIS AUTUMN F | Authorized Representative | 1409 KINGSLEY AVENUE, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-25 | 1409 KINGSLEY AVENUE, SUITE 9F, ORANGE PARK, FL 32073 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-04-03 | 1409 KINGSLEY AVENUE, SUITE 9F, ORANGE PARK, FL 32073 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-04 | 1409 KINGSLEY AVENUE, SUITE 9F, ORANGE PARK, FL 32073 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-25 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-28 |
| ANNUAL REPORT | 2020-06-07 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-04 |
| Florida Limited Liability | 2017-01-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
