| Entity Name: | JANE BISTLINE MD INTERVENTIONAL PAIN, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Oct 2011 (13 years ago) |
| Document Number: | L11000122600 |
| FEI/EIN Number | 45-3692946 |
| Address: | 2031 PALM BEACH LAKES BLVD, SUITE 100, WEST PALM BEACH, FL 33409 |
| Mail Address: | 2031 PALM BEACH LAKES BLVD, SUITE 100, WEST PALM BEACH, FL 33409 |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194001289 | 2011-11-02 | 2011-12-15 | 2031 PALM BEACH LAKES BLVD, SUITE 100, WEST PALM BEACH, FL, 334096501, US | 2031 PALM BEACH LAKES BLVD, SUITE 100, WEST PALM BEACH, FL, 334096501, US | |||||||||||||||||||
|
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| Phone | +1 561-681-9808 |
| Fax | 5616819989 |
Authorized person
| Name | JANE E BISTLINE |
| Role | PRESIDENT |
| Phone | 5616819808 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME64772 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JANEIRO, JEFFREY M | Agent | 3400 TAMIAMI TRL N, SUITE 203, NAPLES, FL 34103 |
| Name | Role | Address |
|---|---|---|
| BISTLINE, JANE E, Dr. | Managing Member | 2031 PALM BEACH LAKES BLVD. SUITE 100, WEST PALM BEACH, FL 33409 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000044706 | CENTER FOR REGENERATIVE MEDICINE OF PALM BEACH | EXPIRED | 2014-05-05 | 2019-12-31 | No data | 2031 PALM BEACH LAKES BLVD., SUITE 100, WEST PALM BEACH, FL, 33409 |
| G11000121644 | INTERVENTIONAL PAIN SERVICES OF PALM BEACH | ACTIVE | 2011-12-14 | 2026-12-31 | No data | 2031 PALM BEACH LAKES BLVD., SUITE 100, WEST PALM BEACH, FL, 33409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-10 | 3400 TAMIAMI TRL N, SUITE 203, NAPLES, FL 34103 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-18 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-04-29 |
| ANNUAL REPORT | 2020-05-25 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-03-13 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-04-10 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State
