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  5. SPINE INSTITUTE, P.A.

SPINE INSTITUTE, P.A.

Company Details

Entity Name: SPINE INSTITUTE, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 20 Apr 2007 (18 years ago)
Date of dissolution: 27 Sep 2024 (4 months ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (4 months ago)
Document Number: P07000048524
FEI/EIN Number 261145504
Address: 1411 North Flagler Drive, Suite 3900, West Palm Beach, FL, 33414, US
Mail Address: P.O. BOX 1101, PALM BEACH, FL, 33480
ZIP code: 33414
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1174848329 2010-03-31 2021-05-07 PO BOX 540064, GREENACRES, FL, 334540064, US 4897 S JOG RD STE A, GREENACRES, FL, 334675000, US

Contacts
Phone +1 561-965-0436
Fax 5619650452

Authorized person
Name DR. STEVEN C CHANG
Role PRESIDENT
Phone 5619650436

Taxonomy
Taxonomy Code 207XS0117X - Orthopaedic Surgery of the Spine Physician
License Number ME90015
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SPINE INSTITUTE 401(K) PLAN 2023 261145504 2024-09-16 SPINE INSTITUTE, P.A. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address PO BOX 1101, PALM BEACH, FL, 33480
SPINE INSTITUTE 401(K) PLAN 2022 261145504 2023-10-09 SPINE INSTITUTE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address PO BOX 1101, PALM BEACH, FL, 33480
SPINE INSTITUTE 401(K) PLAN 2021 261145504 2022-10-24 SPINE INSTITUTE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address PO BOX 1101, PALM BEACH, FL, 33480
SPINE INSTITUTE 401(K) PLAN 2020 261145504 2021-08-30 SPINE INSTITUTE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address 5511 SOUTH CONGRESS AVE, SUITE 101, ATLANTIS, FL, 33462
SPINE INSTITUTE 401(K) PLAN 2019 261145504 2020-04-30 SPINE INSTITUTE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address 5511 SOUTH CONGRESS AVE, SUITE 101, ATLANTIS, FL, 33462
SPINE INSTITUTE 401(K) PLAN 2018 261145504 2019-10-03 SPINE INSTITUTE, P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address 5511 SOUTH CONGRESS AVE, SUITE 101, ATLANTIS, FL, 33462
SPINE INSTITUTE 401(K) PLAN 2017 261145504 2018-09-24 SPINE INSTITUTE, P.A. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address 5511 SOUTH CONGRESS AVE, SUITE 101, ATLANTIS, FL, 33462
SPINE INSTITUTE 401(K) PLAN 2016 261145504 2017-10-04 SPINE INSTITUTE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 5619650436
Plan sponsor’s address 5511 SOUTH CONGRESS AVE, SUITE 101, ATLANTIS, FL, 33462

Agent

Name Role Address
Chang Steven Agent 1411 North Flagler Drive, West Palm Beach, FL, 33414

President

Name Role Address
CHANG STEVEN President P. O. BOX 1101, PALM BEACH, FL, 33480

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 No data No data
CHANGE OF PRINCIPAL ADDRESS 2021-04-03 1411 North Flagler Drive, Suite 3900, West Palm Beach, FL 33414 No data
REGISTERED AGENT ADDRESS CHANGED 2021-04-03 1411 North Flagler Drive, Suite 3900, West Palm Beach, FL 33414 No data
REGISTERED AGENT NAME CHANGED 2013-03-28 Chang, Steven No data
AMENDMENT AND NAME CHANGE 2010-01-21 SPINE INSTITUTE, P.A. No data
CHANGE OF MAILING ADDRESS 2009-06-23 1411 North Flagler Drive, Suite 3900, West Palm Beach, FL 33414 No data

Documents

Name Date
ANNUAL REPORT 2023-04-20
ANNUAL REPORT 2022-04-06
ANNUAL REPORT 2021-04-03
ANNUAL REPORT 2020-04-30
ANNUAL REPORT 2019-04-09
ANNUAL REPORT 2018-01-21
ANNUAL REPORT 2017-05-02
ANNUAL REPORT 2016-04-28
ANNUAL REPORT 2015-04-27
ANNUAL REPORT 2014-04-19

Related by officers

CHANG STEVEN

MOTIONX PRODUCTIONS, LLC CNR CONSULTING GROUP, LLC CHANG REALTY INC ACA UNIVERSITY BLVD., LLC SKJC DENTAL LLC

Chang Steven

CHANG-TOMAR GROUP, LLC 206 PBL LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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