| Entity Name: | DOCTORS' COMPREHENSIVE SPINE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 30 Jul 2004 (21 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | P04000112247 |
| FEI/EIN Number | 371493760 |
| Address: | 1931-A W. DR MARTIN LUTHER KING JR BLVD, TAMPA, FL, 33607 |
| Mail Address: | 1931-A W. DR MARTIN LUTHER KING JR BLVD, TAMPA, FL, 33607 |
| ZIP code: | 33607 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023162906 | 2007-01-22 | 2008-01-18 | 1931 W DR MARTIN LUTHER KING JR BLVD, SUITE A, TAMPA, FL, 336076529, US | 1931 W DR MARTIN LUTHER KING JR BLVD, SUITE A, TAMPA, FL, 336076529, US | |||||||||||||||||||||||||
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| Phone | +1 813-873-9229 |
| Fax | 8138739228 |
Authorized person
| Name | MRS. KIM RUSNAK |
| Role | ADMINISTRATOR |
| Phone | 8138739229 |
Taxonomy
| Taxonomy Code | 111NR0400X - Rehabilitation Chiropractor |
| License Number | CH 5142 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 09529 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROTHBURD CRAIG E | Agent | 808 W DE LEON STREET, TAMPA, FL, 336062722 |
| Name | Role | Address |
|---|---|---|
| MAZZARELLI FRANK D | President | 1931 A W MLK JR BLVD, TAMPA, FL, 33607 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08269900161 | FLORIDA PHYSICAL THERAPY & REHABILITATION CONSULTANTS | EXPIRED | 2008-09-25 | 2013-12-31 | No data | 1931-A W DR MARTIN LUTHER KING, JR BLVD, TAMPA, FL, 33607 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-06-05 | 1931-A W. DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607 | No data |
| CHANGE OF MAILING ADDRESS | 2006-06-05 | 1931-A W. DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607 | No data |
| NAME CHANGE AMENDMENT | 2005-03-09 | DOCTORS' COMPREHENSIVE SPINE CENTER, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2009-01-27 |
| ANNUAL REPORT | 2008-04-28 |
| ANNUAL REPORT | 2007-04-18 |
| ANNUAL REPORT | 2006-06-05 |
| ANNUAL REPORT | 2005-04-13 |
| Off/Dir Resignation | 2005-04-11 |
| Name Change | 2005-03-09 |
| Domestic Profit | 2004-07-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
