| Entity Name: | PAIN MEDICINE INSTITUTE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 22 Oct 2004 (20 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L04000077057 |
| FEI/EIN Number | 201785919 |
| Address: | 6815 14TH STREET WEST, SUITE 204, BRADENTON, FL, 34207 |
| Mail Address: | P.O. BOX 2014, SARASOTA, FL, 34230 |
| ZIP code: | 34207 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992949572 | 2009-04-27 | 2009-04-27 | 6815 14TH ST W, SUITE 204, BRADENTON, FL, 342075810, US | 2325 S TAMIAMI TRL, SUITE B, SARASOTA, FL, 342393807, US | |||||||||||||||||||||||||||
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| Phone | +1 941-758-7300 |
| Fax | 9417587334 |
| Phone | +1 941-758-7330 |
Authorized person
| Name | DR. RAYMON D PRIEWE |
| Role | PRESIDENT/OWNER |
| Phone | 9417587300 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | OS5370 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 80785 |
| State | FL |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| PRIEWE RAYMON DDr. | Manager | 8223 MIDNIGHT PASS RD, SARASOTA, FL, 34242 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08137700001 | MED -PLUS PHYSICAL THERAPY | EXPIRED | 2008-05-16 | 2013-12-31 | No data | P.O. BOX 2014, SARASOTA, FL, 34230 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-01-27 | BLALOCK WALTERS, P.A. | No data |
| CANCEL ADM DISS/REV | 2010-01-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-06-29 | 6815 14TH STREET WEST, SUITE 204, BRADENTON, FL 34207 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-07-30 |
| ANNUAL REPORT | 2013-03-08 |
| ANNUAL REPORT | 2012-01-27 |
| ANNUAL REPORT | 2011-01-27 |
| REINSTATEMENT | 2010-01-19 |
| ANNUAL REPORT | 2008-02-25 |
| ANNUAL REPORT | 2007-01-24 |
| ANNUAL REPORT | 2006-05-04 |
| ANNUAL REPORT | 2005-06-29 |
| Florida Limited Liabilites | 2004-10-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
