| Entity Name: | RL SPINE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Jun 2017 (8 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 29 Sep 2020 (4 years ago) |
| Document Number: | L17000139531 |
| FEI/EIN Number | 822069066 |
| Address: | 7671 CITA LN,, NEW PORT RICHEY, FL, 34653, US |
| Mail Address: | 7671 CITA LN,, NEW PORT RICHEY, FL, 34653, US |
| ZIP code: | 34653 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770081853 | 2018-01-24 | 2018-01-24 | 7671 CITA LN UNIT 101, NEW PORT RICHEY, FL, 346536223, US | 7671 CITA LN UNIT 101, NEW PORT RICHEY, FL, 346536223, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 727-339-3573 |
| Fax | 7273393697 |
Authorized person
| Name | DR. ROBERT DE STEFANO JR. |
| Role | OWNER |
| Phone | 7278087542 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10924 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| License Number | 1952841215 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1952841215 |
| State | FL |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| De Stefano Robert JR | Authorized Member | 7671 Cita Ln., New Port Richey, FL, 34653 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000123620 | FLORIDA SPINE AND INJURY CENTER | ACTIVE | 2017-11-09 | 2027-12-31 | No data | 7671 CITA LANE UNIT 101, NEW PORT RICHEY, FL, 34653 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2020-09-29 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-09-29 | REGISTERED AGENTS INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-09-29 | 7901 4TH ST N, STE 300, ST. PETERSBURG, FL 33702 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-01-10 | 7671 CITA LN,, STE 101, NEW PORT RICHEY, FL 34653 | No data |
| CHANGE OF MAILING ADDRESS | 2018-01-10 | 7671 CITA LN,, STE 101, NEW PORT RICHEY, FL 34653 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-01 |
| CORLCRACHG | 2020-09-29 |
| ANNUAL REPORT | 2020-02-21 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-04-02 |
| Florida Limited Liability | 2017-06-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
