| Entity Name: | VITAL SPINE CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Jan 2018 (7 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P18000003422 |
| Address: | 4063 N GOLDENROD RD, 1, WINTER PARK, FL, 32792, US |
| Mail Address: | 4063 N GOLDENROD RD, 1, WINTER PARK, FL, 32792, US |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316448715 | 2018-02-22 | 2018-02-22 | 4063 N GOLDENROD RD STE 1, WINTER PARK, FL, 327928905, US | 4063 N GOLDENROD RD STE 1, WINTER PARK, FL, 327928905, US | |||||||||||||||||||||||||
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| Phone | +1 407-960-3902 |
| Fax | 4079601745 |
Authorized person
| Name | AHITSHA ORTIZ |
| Role | PRESIDENT |
| Phone | 4079603902 |
Taxonomy
| Taxonomy Code | 111N00000X - Chiropractor |
| License Number | CH10572 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1649536426 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ORTIZ AHITSHA | Agent | 4063 N GOLDENROD RD, WINTER PARK, FL, 32792 |
| Name | Role | Address |
|---|---|---|
| ORTIZ AHITSHA | President | 4063 N GOLDENROD RD, STE.1, WINTER PARK, FL, 32792 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2018-01-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
