| Entity Name: | GULF COAST PAIN MANAGEMENT PHYSICIANS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 29 Oct 2007 (17 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | L07000109383 |
| FEI/EIN Number | 261434326 |
| Address: | 3890 TAMPA ROAD, SUITE 308, PALM HARBOR, FL, 34684 |
| Mail Address: | 3890 TAMPA ROAD, SUITE 308, PALM HARBOR, FL, 34684 |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881877538 | 2007-12-17 | 2007-12-17 | 3890 TAMPA RD, SUITE 308, PALM HARBOR, FL, 346843676, US | 3890 TAMPA RD, SUITE 308, PALM HARBOR, FL, 346843676, US | |||||||||||||||||||||
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| Phone | +1 727-789-0891 |
| Fax | 7277891570 |
Authorized person
| Name | DR. JAN DUVOISIN |
| Role | PHYSICIAN |
| Phone | 7277890891 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 99061 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AEBEL ERIN | Agent | SHUMAKER, LOOP & KENDRICK, LLP, TAMPA, FL, 33602 |
| Name | Role | Address |
|---|---|---|
| COLUMBUS LYNNE C | President | 3890 TAMPA RD STE 308, PALM HARBOR, FL, 34684 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2010-03-30 |
| ANNUAL REPORT | 2009-04-08 |
| ANNUAL REPORT | 2008-05-01 |
| Florida Limited Liability | 2007-10-29 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
