| Entity Name: | CLAY PAIN CENTER PHYSICIANS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
CLAY PAIN CENTER PHYSICIANS, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Mar 2009 (16 years ago) |
| Date of dissolution: | 25 Sep 2015 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (10 years ago) |
| Document Number: | L09000026857 |
| FEI/EIN Number |
264489679
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1564 KINGSLEY AVE, ORANGE PARK, FL, 32073 |
| Mail Address: | 1564 KINGSLEY AVE, ORANGE PARK, FL, 32073 |
| ZIP code: | 32073 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659508273 | 2009-06-22 | 2009-06-24 | PO BOX 864483, ORLANDO, FL, 328864486, US | 1564 KINGSLEY AVE, ORANGE PARK, FL, 320734511, US | |||||||||||||||||
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| Phone | +1 904-264-0400 |
Authorized person
| Name | CARL R. NOBACK |
| Role | MEMBER |
| Phone | 9413601566 |
Taxonomy
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CLAY SURGERY CENTER, LLP | Managing Member | 1564 KINGSLEY AVE., ORANGE PARK, FL, 32073 |
| SHAH HEMANT N | Managing Member | PO BOX 600290, JACKSONVILLE, FL, 32260 |
| BATAINEH MOHAMMAD R | Agent | 1200 RIVERPLACE BLVD., JACKSONVILLE, FL, 32207 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G09000172539 | CLAY PAIN CENTER, LLC | EXPIRED | 2009-11-05 | 2014-12-31 | - | 1564 KINGSLEY AVE, ORANGE PARK, FL, 32073 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | - | - |
| REGISTERED AGENT NAME CHANGED | 2012-05-01 | BATAINEH, MOHAMMAD R | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-05-01 | 1200 RIVERPLACE BLVD., STE 705, JACKSONVILLE, FL 32207 | - |
| LC NAME CHANGE | 2009-06-29 | CLAY PAIN CENTER PHYSICIANS, LLC | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-04-03 |
| ANNUAL REPORT | 2013-04-30 |
| ANNUAL REPORT | 2012-05-01 |
| ANNUAL REPORT | 2011-03-24 |
| ANNUAL REPORT | 2010-04-22 |
| LC Name Change | 2009-06-29 |
| Florida Limited Liability | 2009-03-18 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 339176257 | 0419700 | 2013-07-11 | 1564 KINGSLEY AVE., ORANGE PARK, FL, 32073 | |||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
