| Entity Name: | UNITED PAIN AND SPINE INSTITUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Apr 2020 (5 years ago) |
| Document Number: | L20000109793 |
| FEI/EIN Number | 850829781 |
| Address: | 6100 GREENLAND RD, JACKSONVILLE, FL, 32258, US |
| Mail Address: | 6100 GREENLAND RD, JACKSONVILLE, FL, 32258, US |
| ZIP code: | 32258 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194345520 | 2020-04-27 | 2022-02-22 | 10175 FORTUNE PKWY UNIT 803, JACKSONVILLE, FL, 322566754, US | 10175 FORTUNE PKWY UNIT 803, JACKSONVILLE, FL, 322566754, US | |||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 904-718-6929 |
| Fax | 9042014057 |
Authorized person
| Name | HAITAO ZHANG |
| Role | PRESIDENT |
| Phone | 9047186929 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Taxonomy Code | 2081N0008X - Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 2081P0004X - Spinal Cord Injury Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2081P0301X - Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | Yes |
| Taxonomy Code | 2081S0010X - Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ZHANG HAITAO | Agent | 6100 GREENLAND RD, JACKSONVILLE, FL, 32258 |
| Name | Role | Address |
|---|---|---|
| ZHANG HAITAO | President | 6100 GREENLAND RD, JACKSONVILLE, FL, 32258 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-26 | 6100 GREENLAND RD, #804, JACKSONVILLE, FL 32258 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-26 | 6100 GREENLAND RD, #804, JACKSONVILLE, FL 32258 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-26 | ZHANG, HAITAO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-26 | 6100 GREENLAND RD, #804, JACKSONVILLE, FL 32258 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-02-09 |
| Florida Limited Liability | 2020-04-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
