| Entity Name: | ADVANCED PAIN MANAGEMENT CLINIC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 21 Jul 2009 (16 years ago) |
| Document Number: | L09000070038 |
| FEI/EIN Number | 270583254 |
| Address: | 3003 Claire Lane, BLDG 100, JACKSONVILLE, FL, 32223, US |
| Mail Address: | 3003 Claire Lane, BLDG 100, JACKSONVILLE, FL, 32223, US |
| ZIP code: | 32223 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316179245 | 2009-08-11 | 2010-07-26 | 5757 BOOTH ROAD, BLDG 100, JACKSONVILLE, FL, 32207, US | 5757 BOOTH ROAD, BLDG 100, JACKSONVILLE, FL, 32207, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 904-683-2596 |
| Fax | 9046832597 |
Authorized person
| Name | DR. MICHAEL S WILLENS |
| Role | PRESIDENT |
| Phone | 9046355555 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| License Number | OS8432 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WILLENS MICHAEL D.O. | Agent | 3003 Claire Lane, JACKSONVILLE, FL, 32223 |
| Name | Role | Address |
|---|---|---|
| Willens Michael SD.O. | Chief Executive Officer | 3003 Claire Lane, JACKSONVILLE, FL, 32223 |
| Name | Role | Address |
|---|---|---|
| Willens Sara | Manager | 3003 Claire Lane, JACKSONVILLE, FL, 32223 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2016-01-22 | 3003 Claire Lane, BLDG 100, JACKSONVILLE, FL 32223 | No data |
| CHANGE OF MAILING ADDRESS | 2016-01-22 | 3003 Claire Lane, BLDG 100, JACKSONVILLE, FL 32223 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-01-22 | 3003 Claire Lane, BLDG 100, JACKSONVILLE, FL 32223 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-01-09 | WILLENS, MICHAEL, D.O. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-01-19 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-10 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-01-10 |
| ANNUAL REPORT | 2017-02-12 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-02-21 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
