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  5. PREMIER PAIN SPECIALISTS, LLC

PREMIER PAIN SPECIALISTS, LLC

Company Details

Entity Name: PREMIER PAIN SPECIALISTS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 28 Apr 2008 (17 years ago)
Last Event: CONVERSION
Event Date Filed: 28 Apr 2008 (17 years ago)
Document Number: L08000045063
FEI/EIN Number 651144921
Address: 1228 S.E. 8TH TERRACE, CAPE CORAL, FL, 33990, US
Mail Address: 1228 S.E. 8TH TERRACE, CAPE CORAL, FL, 33990, US
ZIP code: 33990
County: Lee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1962589671 2006-11-01 2021-12-02 1228 SE 8TH TER, CAPE CORAL, FL, 339903210, US 1228 SE 8TH TER, CAPE CORAL, FL, 339903210, US

Contacts
Phone +1 239-945-1105
Fax 2399454495

Authorized person
Name DR. JULES ALVA PREUDHOMME
Role PRESIDENT
Phone 2399451105

Taxonomy
Taxonomy Code 207LP2900X - Pain Medicine (Anesthesiology) Physician
License Number ME72077
State FL
Is Primary Yes

Other Provider Identifiers
Issuer FIRST HEALTH
Number 1132487
State FL
Issuer WORKERS COMPENSATON
Number 0403035
State FL
Issuer ACS
Number 352107800
State FL
Issuer MEDICARE RAILROAD
Number 050085760
State FL
Issuer BLUE CROSS BLUE SHIELD OF
Number 43550
State FL
Issuer BC/BS VIRTUAL
Number 285839
State FL
Issuer AETNA
Number 7040371
State FL
Issuer OXFORD
Number P2816206
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER PAIN SPECIALISTS, LLC 401(K) PS PLAN 2023 651144921 2024-05-29 PREMIER PAIN SPECIALISTS, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990

Signature of
Role Plan administrator
Date 2024-05-29
Name of individual signing JULES A PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-29
Name of individual signing JULES A PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
PREMIER PAIN SPECIALISTS, LLC 401(K) PS PLAN 2022 651144921 2023-07-18 PREMIER PAIN SPECIALISTS, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990

Signature of
Role Plan administrator
Date 2023-07-18
Name of individual signing JULES A. PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
PREMIER PAIN SPECIALISTS, LLC 401(K) PS PLAN 2021 651144921 2022-07-08 PREMIER PAIN SPECIALISTS, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990

Signature of
Role Plan administrator
Date 2022-07-08
Name of individual signing JULES A PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-07-08
Name of individual signing JULES A PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
PREMIER PAIN SPECIALISTS, LLC 401(K) PS PLAN 2020 651144921 2021-08-25 PREMIER PAIN SPECIALISTS, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990

Signature of
Role Plan administrator
Date 2021-08-25
Name of individual signing JULES A PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
PREMIER PAIN SPECIALISTS, LLC 401(K) PROFIT SHARING PLAN 2019 651144921 2020-09-21 PREMIER PAIN SPECIALISTS, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990
PREMIER PAIN SPECIALISTS, LLC 401(K) PROFIT SHARING PLAN 2019 651144921 2020-09-21 PREMIER PAIN SPECIALISTS, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990
PREMIER PAIN SPECIALISTS, LLC 401(K) PS PLAN 2019 651144921 2020-09-02 PREMIER PAIN SPECIALISTS, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990

Signature of
Role Plan administrator
Date 2020-09-02
Name of individual signing JULES PREUDHOMME
Valid signature Filed with authorized/valid electronic signature
PREMIER PAIN SPECIALISTS, LLC 401(K) PROFIT SHARING PLAN 2018 651144921 2019-08-13 PREMIER PAIN SPECIALISTS, LLC 5
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990
PREMIER PAIN SPECIALISTS, LLC 401(K) PROFIT SHARING PLAN 2018 651144921 2020-09-21 PREMIER PAIN SPECIALISTS, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990
PREMIER PAIN SPECIALISTS, LLC 401(K) PROFIT SHARING PLAN 2017 651144921 2018-05-30 PREMIER PAIN SPECIALISTS, LLC 5
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2399451105
Plan sponsor’s address 1228 SE 8TH TERRACE, CAPE CORAL, FL, 33990

Agent

Name Role Address
FLAMMING DONNA M Agent 8891 BRIGHTON LANE, BONITA SPRINGS, FL, 34135

Manager

Name Role Address
PREUDHOMME JULES A Manager 1228 S.E. 8TH TERRACE, CAPE CORAL, FL, 33990

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-03-14 8891 BRIGHTON LANE, SUITE 112, BONITA SPRINGS, FL 34135 No data
CHANGE OF PRINCIPAL ADDRESS 2020-05-01 1228 S.E. 8TH TERRACE, CAPE CORAL, FL 33990 No data
CHANGE OF MAILING ADDRESS 2020-05-01 1228 S.E. 8TH TERRACE, CAPE CORAL, FL 33990 No data
REGISTERED AGENT NAME CHANGED 2015-04-28 FLAMMING, DONNA M No data
CONVERSION 2008-04-28 No data CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P01000098087. CONVERSION NUMBER 300000087373

Documents

Name Date
ANNUAL REPORT 2024-03-05
ANNUAL REPORT 2023-03-14
ANNUAL REPORT 2022-03-11
ANNUAL REPORT 2021-03-23
ANNUAL REPORT 2020-05-01
ANNUAL REPORT 2019-03-21
ANNUAL REPORT 2018-03-13
ANNUAL REPORT 2017-03-16
ANNUAL REPORT 2016-02-29
Reg. Agent Change 2015-04-28

Related by officers

PREUDHOMME JULES A

STELLAR REGENERATION, LLC PREMIER INVESTMENTS AND MANAGEMENT, LLC

FLAMMING DONNA M

ML WILLARD, LLC ERRAND EXPRESS, LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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