| Entity Name: | SAR PAIN INSTITUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 06 Dec 2010 (14 years ago) |
| Date of dissolution: | 27 Apr 2022 (3 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Apr 2022 (3 years ago) |
| Document Number: | L10000125362 |
| FEI/EIN Number | 274118275 |
| Address: | 5624 8TH ST WEST., STE 111, LEHIGH ACRES, FL, 33971, US |
| Mail Address: | P.O. BOX 380877, MURDOCK, FL, 33938, US |
| ZIP code: | 33971 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104104785 | 2011-07-29 | 2023-03-07 | 2706 SE SANTA BARBARA PL, CAPE CORAL, FL, 339042701, US | 2706 SE SANTA BARBARA PL, CAPE CORAL, FL, 339042701, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 239-471-0721 |
| Fax | 2394710732 |
Authorized person
| Name | STEPHEN MARK ROSS |
| Role | MEDICAL DIRECTOR |
| Phone | 2394710721 |
Taxonomy
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| License Number | PMC 1621 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | FK751A |
| State | FL |
| Issuer | PAIN CLINIC |
| Number | PMC1621 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GONZALEZ CRYSTAL L | Agent | 2706 SE SANTA BARBAR PLACE, CAPE CORAL, FL, 33904 |
| Name | Role | Address |
|---|---|---|
| ROSS STEPHEN MMD | MEDI | P.O. BOX 380877, MURDOCK, FL, 33938 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000105900 | SAR MEDICAL INSTITUTE OF CAPE CORAL | EXPIRED | 2014-10-21 | 2019-12-31 | No data | 2706 SE SANTA BARBARA PLACE, CAPE CORAL, FL, 33904 |
| G14000102679 | SAR MEDICAL OF CAPE CORAL | EXPIRED | 2014-10-09 | 2019-12-31 | No data | 2706 SE SANTA BARBARA PLACE, CAPE CORAL, FL, 33904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2022-04-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-09-10 | 5624 8TH ST WEST., STE 111, LEHIGH ACRES, FL 33971 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-04-08 | GONZALEZ, CRYSTAL L | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-02 | 5624 8TH ST WEST., STE 111, LEHIGH ACRES, FL 33971 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-02 | 2706 SE SANTA BARBAR PLACE, CAPE CORAL, FL 33904 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2022-04-27 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-04-08 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-03-12 |
| ANNUAL REPORT | 2017-04-17 |
| ANNUAL REPORT | 2016-04-14 |
| ANNUAL REPORT | 2015-02-02 |
| ANNUAL REPORT | 2014-03-17 |
| ANNUAL REPORT | 2013-04-26 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
