| Entity Name: | FLORIDA SPINE AND SPORT INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 21 Oct 2013 (11 years ago) |
| Document Number: | P13000086239 |
| FEI/EIN Number | 46-3934765 |
| Address: | 2240 SW 70TH AVENUE,, SUITE: D, DAVIE, FL 33317 |
| Mail Address: | 2240 SW 70TH AVENUE,, SUITE: D, DAVIE, FL 33317 |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | FLORIDA SPINE AND SPORT INC, MISSISSIPPI | 1425699 | MISSISSIPPI |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235567363 | 2013-10-29 | 2021-01-06 | 2240 SW 70TH AVE STE D, DAVIE, FL, 333177112, US | 2240 SW 70TH AVE STE D, DAVIE, FL, 333177112, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 954-609-6980 |
| Phone | +1 954-430-8000 |
Authorized person
| Name | MR. ROBERT M KUSTIN |
| Role | MANAGER |
| Phone | 9544308000 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KUSTIN, ROBERT, DR | Agent | 17743 SW 2ND ST., PEMBROKE PINES, FL 33029 |
| Name | Role | Address |
|---|---|---|
| KUSTIN, ROBERT, DR | President | 17743 SW 2ND ST., PEMBROKE PINES, FL 33029 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000137961 | ONE FED | ACTIVE | 2024-11-12 | 2029-12-31 | No data | 2240 SOUTHWEST 70TH AVENUE, DAVIE, FL, 33317 |
| G22000022843 | 4 FED-HURT | ACTIVE | 2022-02-24 | 2027-12-31 | No data | 2240 SW 70TH AVE, SUITE D, DAVIE, FL, 33317 |
| G17000061819 | DOL INJURY CENTERS | EXPIRED | 2017-06-05 | 2022-12-31 | No data | 17743 SW 2 STREET, PEMBROKE PINES, FL, 33029 |
| G15000067474 | PINES SPINE AND JOINT | EXPIRED | 2015-06-29 | 2020-12-31 | No data | 17743 SW 2ND STREET, PEMBROKE PINES, FL, 33029 |
| G13000121081 | PINES PHYSICAL MEDICINE | EXPIRED | 2013-12-11 | 2018-12-31 | No data | 17743 SW 2 STREET, PEMBROKE PINES, FL, 33029 |
| G13000111140 | PINES SPORTS MEDICINE | EXPIRED | 2013-11-12 | 2018-12-31 | No data | 17743 SW 2ND STREET, PEMBROKE PINES, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-09-24 | 2240 SW 70TH AVENUE,, SUITE: D, DAVIE, FL 33317 | No data |
| CHANGE OF MAILING ADDRESS | 2018-09-24 | 2240 SW 70TH AVENUE,, SUITE: D, DAVIE, FL 33317 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-02-21 |
| ANNUAL REPORT | 2021-02-04 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-02-18 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-04-04 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
