Menu
Search icon
  1. Home Page
    2. ›
  2. Counties
    3. ›
  3. Hillsborough
    4. ›
  4. 33629
    5. ›
  5. JOSEPH SPINE, PA

JOSEPH SPINE, PA

Company Details

Entity Name: JOSEPH SPINE, PA
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 11 May 2016 (9 years ago)
Document Number: P16000042573
FEI/EIN Number 81-2658278
Address: 5021 W. SAN MIGUEL STREET, TAMPA, FL 33629
Mail Address: 1840 Mease Dr, Suite 309, Safety Harbor, FL 34695
ZIP code: 33629
County: Hillsborough
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194173260 2016-05-31 2017-01-13 2727 W MLK BLVD, SUITE 590, TAMPA, FL, 336076383, US 2727 W MLK BLVD, STE 590, TAMPA, FL, 336076383, US

Contacts
Phone +1 813-534-6269
Fax 8138700008

Authorized person
Name DR. SAMUEL A JOSEPH JR.
Role OWNER/PRESIDENT
Phone 7272025093

Taxonomy
Taxonomy Code 207XS0117X - Orthopaedic Surgery of the Spine Physician
License Number ME101718
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOSEPH SPINE PA 401(K) PROFIT SHARING PLAN TRUST 2023 812658278 2024-09-04 JOSEPH SPINE PA 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 WEST DR. MARTIN LUTHER KING JR, SUITE 590, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2024-09-04
Name of individual signing SAMUEL JOSEPH JR
Valid signature Filed with authorized/valid electronic signature
JOSEPH SPINE PA 401(K) PROFIT SHARING PLAN TRUST 2022 812658278 2023-10-10 JOSEPH SPINE PA 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 WEST DR. MARTIN LUTHER KING JR, SUITE 590, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2023-10-10
Name of individual signing SAMUEL JOSEPH JR
Valid signature Filed with authorized/valid electronic signature
JOSEPH SPINE PA 401 K PROFIT SHARING PLAN TRUST 2021 812658278 2022-10-10 JOSEPH SPINE PA 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 WEST DR. MARTIN LUTHER KING JR, SUITE 590, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing SAMUEL JOSEPH JR
Valid signature Filed with authorized/valid electronic signature
JOSEPH SPINE PA 401 K PROFIT SHARING PLAN TRUST 2020 812658278 2021-07-22 JOSEPH SPINE PA 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 WEST DR. MARTIN LUTHER KING JR, SUITE 590, TAMPA, FL, 33607
JOSEPH SPINE PA 401 K PROFIT SHARING PLAN TRUST 2019 812658278 2021-02-24 JOSEPH SPINE PA 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 WEST DR. MARTIN LUTHER KING JR, SUITE 590, TAMPA, FL, 33607
JOSEPH SPINE PA 401 K PROFIT SHARING PLAN TRUST 2018 812658278 2019-06-12 JOSEPH SPINE PA 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 WEST DR. MARTIN LUTHER KING JR, SUITE 590, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2019-06-12
Name of individual signing SAMUEL JOSEPH JR
Valid signature Filed with authorized/valid electronic signature
JOSEPH SPINE PA 401 K PROFIT SHARING PLAN TRUST 2017 812658278 2018-10-18 JOSEPH SPINE PA 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621510
Sponsor’s telephone number 7274327153
Plan sponsor’s address 2727 W DR MARTIN LUTHER KING J, SUITE 590, TAMPA, FL, 33607

Signature of
Role Plan administrator
Date 2018-10-18
Name of individual signing SAMUEL JOSEPH JR
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Joseph Spine Institute Agent 1840 Mease Dr, Suite 309, Safety Harbor, FL 34695

Director

Name Role Address
JOSEPH JR, SAMUEL A, M.D. Director 5021 W. San Miguel Street, TAMPA, FL 33629

President

Name Role Address
JOSEPH JR, SAMUEL A, M.D. President 5021 W. San Miguel Street, TAMPA, FL 33629

Secretary

Name Role Address
JOSEPH JR, SAMUEL A, M.D. Secretary 5021 W. San Miguel Street, TAMPA, FL 33629

Treasurer

Name Role Address
JOSEPH JR, SAMUEL A, M.D. Treasurer 5021 W. San Miguel Street, TAMPA, FL 33629

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2024-01-31 5021 W. SAN MIGUEL STREET, TAMPA, FL 33629 No data
REGISTERED AGENT ADDRESS CHANGED 2024-01-31 1840 Mease Dr, Suite 309, Safety Harbor, FL 34695 No data
REGISTERED AGENT NAME CHANGED 2023-01-17 Joseph Spine Institute No data
CHANGE OF PRINCIPAL ADDRESS 2017-04-05 5021 W. SAN MIGUEL STREET, TAMPA, FL 33629 No data

Documents

Name Date
ANNUAL REPORT 2025-01-14
ANNUAL REPORT 2024-01-31
ANNUAL REPORT 2023-01-17
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-01-13
Reg. Agent Change 2020-11-23
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-02-15
ANNUAL REPORT 2018-03-13
ANNUAL REPORT 2017-01-27

Related by officers

No related officers

Related by address

5021 W. SAN MIGUEL STREET, TAMPA, FL 33629

LONGISLAND SPINE, P.A. LONGISLAND, L.L.C. ST. ISLIP, LLC IZLO, LLC JFT INVESTMENTS, LLC

Date of last update: 20 Jan 2025

Sources: Florida Department of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 flprofile.com, Part of Big Data Integrated