| Entity Name: | INSTITUTE OF REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 08 Jan 2021 (4 years ago) |
| Document Number: | L21000021734 |
| FEI/EIN Number | 86-1745612 |
| Address: | 1441 NE 54 ST, FORT LAUDERDALE, FL 33334 |
| Mail Address: | 1441 NE 54 ST, FORT LAUDERDALE, FL 33334 |
| ZIP code: | 33334 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194303487 | 2021-03-30 | 2022-02-21 | 1441 NE 54TH ST, FORT LAUDERDALE, FL, 333344932, US | 3333 W COMMERCIAL BLVD STE 101, FORT LAUDERDALE, FL, 333093424, US | |||||||||||||||||||
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| Phone | +1 786-566-0338 |
Authorized person
| Name | DR. JORGE ANTONIO GONZALEZ |
| Role | OWNER |
| Phone | 7865660338 |
Taxonomy
| Taxonomy Code | 207RS0010X - Sports Medicine (Internal Medicine) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 017619600 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| IROSM CASH BALANCE PENSION PLAN | 2023 | 861745612 | 2024-09-30 | INSTITUTE OF REGENERATIVE ORTHOPEDICS AND SPORTS MEDICINE LLC | 3 | |||||||||||||
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| Name | Role | Address |
|---|---|---|
| GONZALEZ, JORGE A | Agent | 1441 NE 54 ST, FORT LAUDERDALE, FL 33334 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, JORGE A | Manager | 1441 NE 54 ST, FORT LAUDERDALE, FL 33334 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-11 |
| ANNUAL REPORT | 2024-02-03 |
| ANNUAL REPORT | 2023-01-21 |
| ANNUAL REPORT | 2022-01-25 |
| Florida Limited Liability | 2021-01-08 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
