| Entity Name: | THE BRAIN AND SPINE INSTITUTE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Jan 2013 (12 years ago) |
| Date of dissolution: | 12 Jun 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 12 Jun 2018 (7 years ago) |
| Document Number: | P13000004846 |
| FEI/EIN Number | 46-1812133 |
| Address: | 2365 S Congress Ave, WEST PALM BEACH, FL, 33406, US |
| Mail Address: | 2365 S Congress Ave, WEST PALM BEACH, FL, 33406, US |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699114074 | 2013-06-19 | 2016-01-22 | 5 HARVARD CIR, SUITE 104, WEST PALM BEACH, FL, 334091979, US | 5 HARVARD CIR, SUITE 104, WEST PALM BEACH, FL, 334091979, US | |||||||||||||||||||||||||
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| Phone | +1 561-603-6652 |
| Fax | 8885639455 |
Authorized person
| Name | DR. YONAS ZEGEYE |
| Role | PHYSICIAN |
| Phone | 5616036652 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | ME88243 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 270499400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Yeend John S | Agent | 2365 S Congress Ave, WEST PALM BEACH, FL, 33406 |
| Name | Role | Address |
|---|---|---|
| Yeend John S | Secretary | 2365 S Congress Ave, WEST PALM BEACH, FL, 33406 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2018-06-12 | 2365 S Congress Ave, WEST PALM BEACH, FL 33406 | No data |
| VOLUNTARY DISSOLUTION | 2018-06-12 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-06-12 | 2365 S Congress Ave, WEST PALM BEACH, FL 33406 | No data |
| CHANGE OF MAILING ADDRESS | 2018-06-12 | 2365 S Congress Ave, WEST PALM BEACH, FL 33406 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-06-12 | Yeend, John S | No data |
| REINSTATEMENT | 2014-10-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| AMENDMENT | 2013-08-27 | No data | No data |
| ARTICLES OF CORRECTION | 2013-01-22 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J15001001698 | LAPSED | 2015-004990-CC-231 | MIAMI-DADE COUNTY COURT | 2015-10-30 | 2020-11-18 | $6,965.16 | CARECLOUD CORPORATION, C/O SPRECHMAN & FISHER, P.A., 2775 SUNNY ISLES BLVD 100, NORTH MIAMI BEACH, FL 33160 |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2018-06-12 |
| AMENDED ANNUAL REPORT | 2018-06-08 |
| AMENDED ANNUAL REPORT | 2018-06-06 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-01-31 |
| AMENDED ANNUAL REPORT | 2016-04-19 |
| AMENDED ANNUAL REPORT | 2016-03-11 |
| ANNUAL REPORT | 2016-01-21 |
| AMENDED ANNUAL REPORT | 2015-11-05 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
