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Pinnacle Brain and Spine Center, LLC

Details

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) (Companies founded in April 2005)
Entity Number: 000-463-439
Register Number: 000463439
Historical Names: Ronderos Neurosurgery Center, LLC
ZIP code: 36695 (Companies in Mobile, 36695)
County: Mobile
Place of Formation: Mobile County
Registered Office Street Address: 6720 GRELOT ROAD SUITE AMOBILE, AL 36695

Activities PERFORM NEUROSURGERY/PROVIDE PATIENT CARE

National Provider Identifier

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

Contacts

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

form 5500

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
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
RONDEROS NEUROSURGERY CENTER, LLC 401(K) RETIREMENT PLAN 2015 202719929 2016-03-08 RONDEROS NEUROSURGERY CENTER, LLC 8
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
RONDEROS NEUROSURGERY CENTER LLC 401(K) PROFIT SHARING PLAN 2009 202719929 2010-06-16 RONDEROS NEUROSURGERY CENTER LLC 7
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

Agent

Name Role Address
RONDEROS, JUAN F Agent 2363 VENETIA DRIVEMOBILE, AL 36605

Member

Name Role Address
RONDEROS, JUAN F Member 2363 VENETIA DRIVEMOBILE, AL 36605

Events

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