| Entity Name: | BALANCE AND SPINE REHAB LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 Dec 2023 (a year ago) |
| Document Number: | L23000555651 |
| FEI/EIN Number | 93-4894746 |
| Address: | 2140, UNIT 13, ORANGE PARK, FL, 32073 |
| Mail Address: | 2140, UNIT 13, ORANGE PARK, FL, 32073 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548023096 | 2024-02-06 | 2024-02-06 | 5101 GATE PKWY STE 2, JACKSONVILLE, FL, 322567276, US | 2140 KINGSLEY AVE STE 13, ORANGE PARK, FL, 320735129, US | |||||||||||||
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| Phone | +1 904-374-3672 |
Authorized person
| Name | MICHAEL SANDBORN |
| Role | OWNER/PHYSICIAN |
| Phone | 9043743672 |
Taxonomy
| Taxonomy Code | 261QP2000X - Physical Therapy Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LUPI MICHAEL | Agent | 5101 GATE PARKWAY, JACKSONVILLE, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| LUPI MICHAEL | Manager | 5101 GATE PARKWAY, JACKSONVILLE, FL, 32256 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-22 |
| Florida Limited Liability | 2023-12-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
