| Entity Name: | GULF COAST PAIN CONSULTANTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Feb 2013 (12 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 17 Apr 2018 (7 years ago) |
| Document Number: | L13000023220 |
| FEI/EIN Number | 46-2054352 |
| Address: | 4901 B Grande Drive, Pensacola, FL, 32504, US |
| Mail Address: | 201 DEFENSE HIGHWAY, STE 205, ANNAPOLIS, MD, 21401, US |
| ZIP code: | 32504 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083455299 | 2024-06-03 | 2024-06-03 | 201 DEFENSE HWY STE 205, ANNAPOLIS, MD, 214017096, US | 918 MAR WALT DR, FORT WALTON BEACH, FL, 325476706, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 855-527-7246 |
| Fax | 8662295063 |
| Fax | 8339052461 |
Authorized person
| Name | KACEY A MONTGOMERY |
| Role | REGIONAL MEDICAL DIRECTOR |
| Phone | 8507916895 |
Taxonomy
| Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
| Is Primary | No |
| Taxonomy Code | 2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0000X - Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role |
|---|---|
| CLEARWAY PAIN SOLUTIONS INSTITUTE, LLC | Auth |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000020677 | CLEARWAY PAIN SOLUTIONS | ACTIVE | 2020-02-16 | 2025-12-31 | No data | PO BOX 11637, PENSACOLA, FL, 32524 |
| G19000034422 | CLEARWAY PAIN SOLUTIONS INSTITUTE | EXPIRED | 2019-03-14 | 2024-12-31 | No data | PO BOX 11637, PENSACOLA, FL, 32524 |
| G19000002697 | CLEARWAY PAIN SOLUTIONS INSTITUTE | EXPIRED | 2019-01-07 | 2024-12-31 | No data | 5102 NORTH DAVIS HWY., PENSACOLA, FL, 32503 |
| G19000002696 | CLEARWAY | EXPIRED | 2019-01-07 | 2024-12-31 | No data | 5102 NORTH DAVIS HWY., PENSACOLA, FL, 32503 |
| G18000062313 | CLEARWAY PAIN SOLUTIONS INSTITUTE | EXPIRED | 2018-05-24 | 2023-12-31 | No data | 5102 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| G18000062316 | CLEARWAY | EXPIRED | 2018-05-24 | 2023-12-31 | No data | 5102 NORTH DAVIS HIGHWAY, PENSACOLA, FL, 32503 |
| G13000029821 | GULF COAST PAIN INSTITUTE | EXPIRED | 2013-03-27 | 2018-12-31 | No data | 698 BRENT LANE, PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-09 | 4901 B Grande Drive, Pensacola, FL 32504 | No data |
| CHANGE OF MAILING ADDRESS | 2020-07-27 | 4901 B Grande Drive, Pensacola, FL 32504 | No data |
| LC AMENDMENT | 2018-04-17 | No data | No data |
| LC AMENDED/RESTATED ARTICLE/NAME CHANGE | 2018-02-23 | GULF COAST PAIN CONSULTANTS, LLC | No data |
| REGISTERED AGENT NAME CHANGED | 2018-02-23 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-23 | 1200 S PINE ISLAND RD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-07-27 |
| ANNUAL REPORT | 2019-02-08 |
| LC Amendment | 2018-04-17 |
| LC Amended/Restated Article/NC | 2018-02-23 |
| ANNUAL REPORT | 2018-01-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
