| Entity Name: | SPINE AND ORTHOPEDIC SPECIALISTS OF TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Mar 2019 (6 years ago) |
| Document Number: | L19000078456 |
| FEI/EIN Number | 84-3576926 |
| Address: | 2047 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL 33409 |
| Mail Address: | 2047 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL 33409 |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346886033 | 2019-11-18 | 2024-01-24 | 2047 PALM BEACH LAKES BLVD STE 100, WEST PALM BEACH, FL, 334096500, US | 6919 N DALE MABRY HWY STE 325, TAMPA, FL, 336143860, US | |||||||||||||||||||||
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| Phone | +1 561-721-6880 |
| Fax | 5616008705 |
| Phone | +1 561-507-0800 |
Authorized person
| Name | CARIANNE YANTZ |
| Role | ASSISTANT ADMIN |
| Phone | 5619083204 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CUTLER, JONATHAN | Agent | 2047 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL 33409 |
| Name | Role | Address |
|---|---|---|
| CUTLER, JONATHAN | Manager | 2047 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL 33409 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-03-30 |
| ANNUAL REPORT | 2020-01-18 |
| Florida Limited Liability | 2019-03-20 |
Date of last update: 17 Jan 2025
Sources: Florida Department of State
