| Entity Name: | CENTRAL FLORIDA SPINE & PAIN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 Mar 2020 (5 years ago) |
| Document Number: | L20000068417 |
| FEI/EIN Number | 84-5021096 |
| Address: | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 |
| Mail Address: | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 |
| ZIP code: | 32904 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851904916 | 2020-08-28 | 2023-06-06 | 395 S WICKHAM RD, MELBOURNE, FL, 329041135, US | 395 S WICKHAM RD, MELBOURNE, FL, 329041135, US | |||||||||||||||
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| Phone | +1 321-802-5021 |
| Fax | 3218024999 |
Authorized person
| Name | NICHOLAS LOUIS GIORDANO |
| Role | OWNER |
| Phone | 3218025021 |
Taxonomy
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRAL FLORIDA SPINE & PAIN | 2023 | 845021096 | 2024-08-10 | CENTRAL FLORIDA SPINE & PAIN LLC | 13 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-08-10 |
| Name of individual signing | NICK RICE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-10-01 |
| Business code | 621498 |
| Sponsor’s telephone number | 9177479952 |
| Plan sponsor’s address | 5059 ALAMANDA DR, MELBOURNE, FL, 32940 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-12 |
| Name of individual signing | SHIRLEY HORNER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| GIORDANO, NICHOLAS L | Agent | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 |
| Name | Role | Address |
|---|---|---|
| GIORDANO, NICHOLAS L | Manager | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-02-01 | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-01 | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-01 | 395 S. WICKHAM ROAD, MELBOURNE, FL 32904 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-02-01 |
| Florida Limited Liability | 2020-03-02 |
Date of last update: 15 Feb 2025
Sources: Florida Department of State
