| Entity Name: | SPINE BRAIN AND JOINT INSTITUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 31 Dec 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Nov 2020 (4 years ago) |
| Document Number: | L20000007865 |
| FEI/EIN Number | 843601778 |
| Address: | 5101 GATE PKWY, STE 2, jacksonville, FL, 32256, US |
| Mail Address: | 5101 GATE PKWY STE 2, JACKSONVILLE, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679110142 | 2019-12-04 | 2021-07-12 | 5101 GATE PKWY STE 2, JACKSONVILLE, FL, 322567276, US | 5101 GATE PKWY STE 2, JACKSONVILLE, FL, 322567276, US | |||||||||||||||
|
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| Phone | +1 904-374-3672 |
| Fax | 9048137156 |
Authorized person
| Name | DR. MICHAEL JAMES LUPI |
| Role | PHYSICIAN |
| Phone | 9122300113 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LUPI MICHAEL Dr. | Agent | 5101 GATE PKWY, STE 2, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| LUPI MICHAEL | Authorized Member | 5101 GATE PKWY STE 2, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| SANDBORN MICHAEL Dr. | Auth | 5101 GATE PKWY, STE 2, JACKSONVILLE, FL, 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-24 | 5101 GATE PKWY, STE 2, JACKSONVILLE, FL 32256 | No data |
| REINSTATEMENT | 2020-11-04 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-11-04 | 5101 GATE PKWY, STE 2, jacksonville, FL 32256 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-11-04 | LUPI, MICHAEL, Dr. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-08-26 | 5101 GATE PKWY, STE 2, jacksonville, FL 32256 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-15 |
| ANNUAL REPORT | 2023-01-24 |
| ANNUAL REPORT | 2022-01-17 |
| ANNUAL REPORT | 2021-02-05 |
| REINSTATEMENT | 2020-11-04 |
| Florida Limited Liability | 2019-12-31 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
