| Entity Name: | ALLIANCE MEDICAL PAIN MANAGEMENT, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Oct 2002 (22 years ago) |
| Document Number: | L02000026614 |
| FEI/EIN Number | 562297129 |
| Address: | 5802 Grand Sonata Ave, Lutz, FL, 33558, US |
| Mail Address: | 5802 Grand Sonata Ave, Lutz, FL, 33558, US |
| ZIP code: | 33558 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558488452 | 2007-03-23 | 2007-09-14 | 10213 LAKE CARROLL WAY, SUITE A, TAMPA, FL, 336184405, US | 10213 LAKE CARROLL WAY, SUITE A, TAMPA, FL, 336184405, US | |||||||||||||||||||||
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| Phone | +1 813-877-6191 |
| Fax | 8138776195 |
Authorized person
| Name | CARISSA H STONE |
| Role | PRESIDENT |
| Phone | 8138776191 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 27936Y |
| State | FL |
| Name | Role | Address |
|---|---|---|
| STONE ERIC | Agent | 5802 Grand Sonata Ave, Lutz, FL, 33558 |
| Name | Role | Address |
|---|---|---|
| STONE CARISSA D | Managing Member | 5802 Grand Sonata Ave, Lutz, FL, 33558 |
| STONE ERIC | Managing Member | 5802 Grand Sonata Ave, Lutz, FL, 33558 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2014-10-06 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| REINSTATEMENT | 2013-10-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REINSTATEMENT | 2003-10-29 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-26 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
