| Entity Name: | NORTH FLORIDA ORTHOPEDIC AND SPINE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 May 2021 (4 years ago) |
| Document Number: | L21000203412 |
| Address: | 657 E. ROMANA ST., PENSACOLA, FL, 32502 |
| Mail Address: | 657 E. ROMANA ST., PENSACOLA, FL, 32502 |
| ZIP code: | 32502 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609548254 | 2021-10-01 | 2023-05-25 | 4400 STATE HIGHWAY 121 STE 405, LEWISVILLE, TX, 75056, US | 657 E ROMANA ST, PENSACOLA, FL, 325026111, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 469-459-9754 |
| Phone | +1 850-446-2909 |
Authorized person
| Name | SETH JACKNOWITZ |
| Role | CRO |
| Phone | 4694599754 |
Taxonomy
| Taxonomy Code | 207XS0117X - Orthopaedic Surgery of the Spine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COGENCY GLOBAL INC. | Agent |
| Name | Role | Address |
|---|---|---|
| BRIAN REECE, M.D. | Authorized Member | 12222 MERIT DRIVE, SUITE 1200, DALLAS, TX, 75251 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000064372 | PALMETTO BRAIN,SPINE & ORTHOPEDIC | ACTIVE | 2023-05-24 | 2028-12-31 | No data | 1300 N. PALAFOX ST.UNIT 104, PENSACOLA, FL, 32502 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2021-05-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
