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SPACE COAST SPINE AND PAIN INSTITUTE LLC - Florida Company Profile

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Company Details

Entity Name: SPACE COAST SPINE AND PAIN INSTITUTE LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

SPACE COAST SPINE AND PAIN INSTITUTE LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 24 Dec 2019 (6 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 22 Feb 2021 (4 years ago)
Document Number: L20000004554
FEI/EIN Number 84-4204158

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 205 EAST NASA BOULEVARD, MELBOURNE, FL, 32901, US
Mail Address: 205 EAST NASA BOULEVARD, MELBOURNE, FL, 32901, US
ZIP code: 32901
County: Brevard
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PATEL MARKAND J Manager 285 LANSING ISLAND DRIVE, INDIAN HARBOR BEACH, FL, 32937
STEPHENS WILLIAM G Manager 1508 PINE STREET, MELBOURNE BEACH, FL, 32951
ALVAREZ JOSE AIII Manager 2585 WOODS LANE, MELBOURNE, FL, 32934
PATEL MARKAND J Agent 285 LANSING ISLAND DRIVE, INDIAN HARBOR BEACH, FL, 32937

National Provider Identifier

NPI Number:
1093388217
Certification Date:
2021-07-24

Authorized Person:

Name:
SONYA WARNICK
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
No
Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
844204158
Plan Year:
2023
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
3
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2021-07-28 205 EAST NASA BOULEVARD, MELBOURNE, FL 32901 -
CHANGE OF PRINCIPAL ADDRESS 2021-07-26 205 EAST NASA BOULEVARD, MELBOURNE, FL 32901 -
REINSTATEMENT 2021-02-22 - -
REGISTERED AGENT NAME CHANGED 2021-02-22 PATEL, MARKAND J -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 - -

Documents

Name Date
ANNUAL REPORT 2024-07-12
ANNUAL REPORT 2023-01-30
ANNUAL REPORT 2022-03-09
REINSTATEMENT 2021-02-22
Florida Limited Liability 2019-12-24

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Date of last update: 02 Jun 2025

Sources: Florida Department of State