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  5. ADVANCED INTERVENTIONAL PAIN CLINIC, LLC

ADVANCED INTERVENTIONAL PAIN CLINIC, LLC

Company Details

Entity Name: ADVANCED INTERVENTIONAL PAIN CLINIC, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 16 Jun 2008 (17 years ago)
Date of dissolution: 25 Sep 2020 (4 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2020 (4 years ago)
Document Number: L08000059034
FEI/EIN Number 800199779
Address: 7000 SW 97th Ave, Suite 214, Miami, FL, 33173, US
Mail Address: 7000 SW 97th Ave, Suite 214, Miami, FL, 33173, US
ZIP code: 33173
County: Miami-Dade
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245678879 2013-06-05 2014-11-26 1170 S SEMORAN BLVD, ORLANDO, FL, 328071458, US 1530 CITRUS MEDICAL CT, SUITE 101, OCOEE, FL, 347614548, US

Contacts
Phone +1 407-622-7246
Fax 4075997246

Authorized person
Name MR. SWAMY YATHAM
Role DIRECTOR
Phone 4076227246

Taxonomy
Taxonomy Code 208VP0014X - Interventional Pain Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC 401(K) PROFIT SHARING PLAN 2016 800199779 2017-10-06 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2017-10-06
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-10-06
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC 401(K) PROFIT SHARING PLAN 2015 800199779 2016-07-24 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2016-07-24
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-24
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC 401(K) PROFIT SHARING PLAN 2014 800199779 2015-09-23 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2015-09-23
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-23
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC CASH BALANCE PLAN 2014 800199779 2015-09-23 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2015-09-23
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-23
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC 401(K) PROFIT SHARING PLAN 2013 800199779 2014-03-28 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2014-03-28
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC CASH BALANCE PLAN 2013 800199779 2014-03-28 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2014-03-28
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC CASH BALANCE PLAN 2012 800199779 2013-04-26 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2013-04-26
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-26
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
ADVANCED INTERVENTIONAL PAIN CLINIC, LLC 401(K) PROFIT SHARING PLAN 2012 800199779 2013-04-26 ADVANCED INTERVENTIONAL PAIN CLINIC , LLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 4076227246
Plan sponsor’s address 1170 S. SEMORAN BOULEVARD, ORLANDO, FL, 32807

Signature of
Role Plan administrator
Date 2013-04-26
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-26
Name of individual signing VENKATA YATHAM
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
YATHAM PADMAJA R Agent 7000 SW 97th Ave, Suite 214, Miami, FL, 33173

Managing Member

Name Role Address
YATHAM PADMAJA R Managing Member 7000 SW 97th Ave, Suite 214, Miami, FL, 33173

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000025934 ADVANCED INTERVENTIONAL SPINE & REHABILITATION CENTER EXPIRED 2012-03-14 2017-12-31 No data 1170 S SEMORAN BLVD, ORLANDO, FL, 32807
G11000039155 ADVANCED AESTHESTICS AND WELLNESS EXPIRED 2011-04-21 2016-12-31 No data 1170 S SEMORAN BLVD, ORLANDO, FL, 32807
G08191900035 ADVANCED INTERVENTIONAL PAIN CLINIC EXPIRED 2008-07-07 2013-12-31 No data 1170C S SEMORAN BLVD, ORLANDO, FL, 32807

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2018-02-01 7000 SW 97th Ave, Suite 214, Miami, FL 33173 No data
CHANGE OF MAILING ADDRESS 2018-02-01 7000 SW 97th Ave, Suite 214, Miami, FL 33173 No data
REGISTERED AGENT ADDRESS CHANGED 2018-02-01 7000 SW 97th Ave, Suite 214, Miami, FL 33173 No data
REGISTERED AGENT NAME CHANGED 2012-01-15 YATHAM, PADMAJA R No data

Documents

Name Date
ANNUAL REPORT 2019-03-24
ANNUAL REPORT 2018-02-01
ANNUAL REPORT 2017-01-07
ANNUAL REPORT 2016-01-15
ANNUAL REPORT 2015-03-18
ANNUAL REPORT 2014-03-10
ANNUAL REPORT 2013-01-15
ANNUAL REPORT 2012-01-15
ANNUAL REPORT 2011-02-22
ANNUAL REPORT 2010-01-24

Related by officers

YATHAM PADMAJA R

ADVANCED AESTHETICS AND WELLNESS, LLC PUJA HOLDINGS, LLC APOLLO PAIN CARE, LLC MARUTI REALTY, LLC

Related by address

7000 SW 97th Ave, Suite 214, Miami, FL, 33173, US

APOLLO PAIN CARE, LLC

7000 SW 97th Ave, Suite 214, Miami, FL, 33173, US

APOLLO PAIN CARE, LLC

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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