| Name: | Pinnacle Brain and Spine Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Apr 2005 (20 years ago) |
| Entity Number: | 000-463-439 |
| Register Number: | 000463439 |
| Historical Names: |
Ronderos Neurosurgery Center, LLC
|
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 6720 GRELOT ROAD SUITE AMOBILE, AL 36695 |
| Registered Office Street Address ZIP Code: | 36695 |
Activities
PERFORM NEUROSURGERY/PROVIDE PATIENT CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457462731 | 2006-08-31 | 2013-09-09 | 6701 AIRPORT BLVD STE D146, MOBILE, AL, 366086701, US | 6701 AIRPORT BLVD STE D146, MOBILE, AL, 366086701, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 251-633-5155 |
| Fax | 2516335125 |
Authorized person
| Name | DR. JUAN FELIX RONDEROS |
| Role | MD/OWNER |
| Phone | 2516335155 |
Taxonomy
| Taxonomy Code | 207T00000X - Neurological Surgery Physician |
| License Number | 00012906 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529923400 |
| State | AL |
| Issuer | MEDICARE RAILROAD |
| Number | DD3322 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RONDEROS NEUROSURGERY CENTER, LLC 401(K) | 2015 | 202719929 | 2016-03-08 | RONDEROS NEUROSURGERY CENTER, LLC | 12 | |||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2016-03-08 |
| Name of individual signing | JUAN RONDEROS |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2516335155 |
| Plan sponsor’s address | 6701 AIRPORT BLVD SUITE D146, MOBILE, AL, 36608 |
Signature of
| Role | Plan administrator |
| Date | 2016-03-08 |
| Name of individual signing | JUAN RONDEROS |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2006-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2516335155 |
| Plan sponsor’s address | 6701 AIRPORT BLVD, STE B 114, MOBILE, AL, 36608 |
Plan administrator’s name and address
| Administrator’s EIN | 202719929 |
| Plan administrator’s name | RONDEROS NEUROSURGERY CENTER LLC |
| Plan administrator’s address | 6701 AIRPORT BLVD, STE B114, MOBILE, AL, 36608 |
| Administrator’s telephone number | 2516335155 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-16 |
| Name of individual signing | JUAN RONDEROS |
| Name | Role | Address |
|---|---|---|
| RONDEROS, JUAN F | Agent | 2363 VENETIA DRIVEMOBILE, AL 36605 |
| Name | Role | Address |
|---|---|---|
| RONDEROS, JUAN F | Member | 2363 VENETIA DRIVEMOBILE, AL 36605 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2019-01-16 | Name Change | Ronderos Neurosurgery Center, LLC | Pinnacle Brain and Spine Center, LLC |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
