| Entity Name: | IPS OF PALM COAST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 11 Feb 2009 (16 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 years ago) |
| Document Number: | L09000014030 |
| Address: | 201 MONTGOMERY AVE, SARASOTA, FL 34243 |
| Mail Address: | 201 MONTGOMERY AVE, SARASOTA, FL 34243 |
| ZIP code: | 34243 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962644914 | 2009-04-06 | 2009-04-06 | PO BOX 864483, ORLANDO, FL, 328864483, US | 21 HOSPITAL DR, STE 220, PALM COAST, FL, 321642452, US | |||||||||||||||||
|
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| Phone | +1 386-263-6020 |
Authorized person
| Name | CARL R. NOBACK |
| Role | MEDICAL DIRECTOR |
| Phone | 9413601566 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| A1A REGISTERED AGENTS, INC. | Agent | 5647 110TH AVE NORTH, ROYAL PALM BEACH, FL 33411 |
| Name | Role |
|---|---|
| INNOVATIVE PAIN SOLUTIONS, LLC | Managing Member |
| MUA OF PALM COAST, PLLC | Managing Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| LC AMENDMENT | 2009-02-24 | No data | No data |
| Name | Date |
|---|---|
| LC Amendment | 2009-02-24 |
| Florida Limited Liability | 2009-02-11 |
Date of last update: 26 Jan 2025
Sources: Florida Department of State
