| Entity Name: | ADVANCED SPINE AND PAIN LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 21 Feb 2024 (a year ago) |
| Document Number: | L24000092375 |
| Address: | 3355 BURNS ROAD, SUITE 102, PALM BEACH GARDENS, FL 33410 UN |
| Mail Address: | 748 LAKESIDE DRIVE, SUITE 102, NORTH PALM BEACH, FL 33408 UN |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295592798 | 2024-03-01 | 2024-03-01 | 3355 BURNS RD STE 102, PALM BEACH GARDENS, FL, 334104354, US | 3355 BURNS RD STE 102, PALM BEACH GARDENS, FL, 334104354, US | |||||||||||||
|
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| Phone | +1 561-628-5039 |
Authorized person
| Name | RAVI XAVIER |
| Role | OWNER |
| Phone | 5616285039 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| XAVIER, RAVI | Agent | 3355 BURNS ROAD, SUITE 102, PALM BEACH GARDENS, FL 33410 |
| Name | Role | Address |
|---|---|---|
| XAVIER, RAVI | Manager | 3355 BURNS ROAD, SUITE 102, PALM BEACH GARDENS, FL 33410 UN |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-02-21 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
