| Entity Name: | TAMPA PAIN MANAGEMENT LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Jan 2012 (13 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L12000014149 |
| FEI/EIN Number | 45-4520822 |
| Address: | 2711 LETAP COURT, LAND O'LAKES, FL, 34638, US |
| Mail Address: | 2711 LETAP COURT, LAND O'LAKES, FL, 34638, US |
| ZIP code: | 34638 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184051708 | 2013-09-27 | 2016-02-01 | 18886 PAMPASS GRASS LN, LUTZ, FL, 335587300, US | 4910 N ARMENIA AVE, TAMPA, FL, 336031402, US | |||||||||||||||||||||
|
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| Phone | +1 813-205-4550 |
| Fax | 8139327264 |
| Phone | +1 813-932-7246 |
Authorized person
| Name | KATHLEEN VAES |
| Role | OWNER |
| Phone | 8132054550 |
Taxonomy
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| License Number | HCC9537 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MAXWELL DAVID DR | Agent | 4 PEARL DRIVE, ORMOND BEACH, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| VAES KATHLEEN | Manager | 2342 Carolton Rd, Maitland, FL, 32751 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| LC STMNT OF RA/RO CHG | 2016-10-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-11 | MAXWELL, DAVID, DR | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-11 | 4 PEARL DRIVE, SUITE 3, ORMOND BEACH, FL 32174 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-09-13 | 2711 LETAP COURT, SUITE 102, LAND O'LAKES, FL 34638 | No data |
| CHANGE OF MAILING ADDRESS | 2016-09-13 | 2711 LETAP COURT, SUITE 102, LAND O'LAKES, FL 34638 | No data |
| Name | Date |
|---|---|
| CORLCRACHG | 2016-10-11 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-01-12 |
| ANNUAL REPORT | 2014-01-16 |
| ANNUAL REPORT | 2013-04-16 |
| Florida Limited Liability | 2012-01-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
