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  5. SOUTH FLORIDA SPINE CLINIC, INC.

SOUTH FLORIDA SPINE CLINIC, INC.

Company Details

Entity Name: SOUTH FLORIDA SPINE CLINIC, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 01 May 2000 (25 years ago)
Last Event: AMENDMENT
Event Date Filed: 03 Sep 2019 (5 years ago)
Document Number: P00000044461
FEI/EIN Number 651021857
Address: 3000 BAYVIEW DRIVE, FT. LAUDERDALE, FL, 33306, US
Mail Address: 3000 BAYVIEW DRIVE, FT. LAUDERDALE, FL, 33306, US
ZIP code: 33306
County: Broward
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1679699557 2007-03-22 2010-04-28 3000 BAYVIEW DRIVE, FT LAUDERDALE, FL, 33306, US 3000 BAYVIEW DRIVE, FT LAUDERDALE, FL, 33306, US

Contacts
Phone +1 954-567-1332
Fax 9545377705

Authorized person
Name DR. JEFFREY B. CANTOR
Role OWNER
Phone 9545671332

Taxonomy
Taxonomy Code 207XS0117X - Orthopaedic Surgery of the Spine Physician
Is Primary Yes
Taxonomy Code 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH FLORIDA SPINE CLINIC, INC. 401(K) PLAN 2011 651021857 2013-03-15 SOUTH FLORIDA SPINE CLINIC, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-11-01
Business code 621111
Sponsor’s telephone number 9545671332
Plan sponsor’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306

Plan administrator’s name and address
Administrator’s EIN 651021857
Plan administrator’s name SOUTH FLORIDA SPINE CLINIC, INC.
Plan administrator’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306
Administrator’s telephone number 9545671332

Signature of
Role Plan administrator
Date 2013-03-15
Name of individual signing SHARON SANTOS
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA SPINE CLINIC, INC. 401(K) PLAN 2010 651021857 2011-09-22 SOUTH FLORIDA SPINE CLINIC, INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-11-01
Business code 621111
Sponsor’s telephone number 9547712551
Plan sponsor’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306

Plan administrator’s name and address
Administrator’s EIN 651021857
Plan administrator’s name SOUTH FLORIDA SPINE CLINIC, INC.
Plan administrator’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306
Administrator’s telephone number 9547712551

Signature of
Role Plan administrator
Date 2011-09-22
Name of individual signing SHARON SANTOS
Valid signature Filed with authorized/valid electronic signature
SOUTH FLORIDA SPINE CLINIC, INC. 401(K) PLAN 2009 651021857 2010-07-19 SOUTH FLORIDA SPINE CLINIC, INC. 35
Three-digit plan number (PN) 001
Effective date of plan 2001-11-01
Business code 621111
Sponsor’s telephone number 9547712551
Plan sponsor’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306

Plan administrator’s name and address
Administrator’s EIN 651021857
Plan administrator’s name SOUTH FLORIDA SPINE CLINIC, INC.
Plan administrator’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306
Administrator’s telephone number 9547712551

Signature of
Role Plan administrator
Date 2010-07-19
Name of individual signing YOSHI BARREIRINHAS
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2010-07-19
Name of individual signing YOSHI BARREIRINHAS
Valid signature Filed with incorrect/unrecognized electronic signature
SOUTH FLORIDA SPINE CLINIC, INC. 401(K) PLAN 2009 651021857 2010-07-19 SOUTH FLORIDA SPINE CLINIC, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-11-01
Business code 621111
Sponsor’s telephone number 9547712551
Plan sponsor’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306

Plan administrator’s name and address
Administrator’s EIN 651021857
Plan administrator’s name SOUTH FLORIDA SPINE CLINIC, INC.
Plan administrator’s address 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306
Administrator’s telephone number 9547712551

Signature of
Role Plan administrator
Date 2010-07-19
Name of individual signing YOSHI BARREIRINHAS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-19
Name of individual signing YOSHI BARREIRINHAS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
CANTOR JEFFREY Agent 3000 BAYVIEW DRIVE, FT. LAUDERDALE, FL, 33306

President

Name Role Address
CANTOR JEFFREY President 3000 BAYVIEW DR., FT. LAUDERDALE, FL, 33306

Secretary

Name Role Address
CANTOR JEFFREY Secretary 3000 BAYVIEW DR., FT. LAUDERDALE, FL, 33306

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000053395 CANTOR SPINE INSTITUTE EXPIRED 2014-06-03 2019-12-31 No data 3000 BAYVIEW DRIVE, FORT LAUDERDALE, FL, 33306

Events

Event Type Filed Date Value Description
AMENDMENT 2019-09-03 No data No data
REGISTERED AGENT NAME CHANGED 2009-12-11 CANTOR, JEFFREY No data
CHANGE OF PRINCIPAL ADDRESS 2003-04-17 3000 BAYVIEW DRIVE, FT. LAUDERDALE, FL 33306 No data
CHANGE OF MAILING ADDRESS 2003-04-17 3000 BAYVIEW DRIVE, FT. LAUDERDALE, FL 33306 No data
REGISTERED AGENT ADDRESS CHANGED 2003-04-17 3000 BAYVIEW DRIVE, FT. LAUDERDALE, FL 33306 No data

Documents

Name Date
ANNUAL REPORT 2024-04-25
ANNUAL REPORT 2023-03-12
ANNUAL REPORT 2022-04-08
ANNUAL REPORT 2021-08-24
ANNUAL REPORT 2020-03-17
Amendment 2019-09-03
ANNUAL REPORT 2019-04-20
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-04-24
ANNUAL REPORT 2016-04-28

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Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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