| Entity Name: | SPINE SENTRIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 19 May 2022 (3 years ago) |
| Document Number: | L22000235063 |
| FEI/EIN Number | 85-5337862 |
| Address: | 2719 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020 |
| Mail Address: | 2719 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020 |
| ZIP code: | 33020 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962123224 | 2022-09-06 | 2022-09-06 | 2719 HOLLYWOOD BLVD # A-2014, HOLLYWOOD, FL, 330204821, US | 2719 HOLLYWOOD BLVD # A-2014, HOLLYWOOD, FL, 330204821, US | |||||||||||||
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| Phone | +1 954-354-2555 |
Authorized person
| Name | ELEANOR OSTBERG |
| Role | BILLING/CREDENTIALING SPECIALIST |
| Phone | 5614202881 |
Taxonomy
| Taxonomy Code | 246ZE0600X - Electroneurodiagnostic Specialist/Technologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FRIDAY, LATOYA | Agent | 2719 Hollywood Blvd, A-2014, HOLLYWOOD, FL 30320 |
| Name | Role | Address |
|---|---|---|
| FRIDAY, LATOYA | Authorized Member | 2719 Hollywood Blvd, A-2014 HOLLYWOOD, FL 33020 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-07 | FRIDAY, LATOYA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-07 | 2719 Hollywood Blvd, A-2014, HOLLYWOOD, FL 30320 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-07-07 | 2719 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020 | No data |
| CHANGE OF MAILING ADDRESS | 2022-07-07 | 2719 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-04-25 |
| Florida Limited Liability | 2022-05-19 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
