| Entity Name: | FLORIDA PAIN MEDICINE, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 31 Oct 2014 (10 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L14000171140 |
| FEI/EIN Number | 47-2401211 |
| Address: | 1909 HAVEN BEND, TAMPA, FL, 33613 |
| Mail Address: | 1909 HAVEN BEND, TAMPA, FL, 33613 |
| ZIP code: | 33613 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861890584 | 2014-12-11 | 2014-12-11 | 2553 WINDGUARD CIR, WESLEY CHAPEL, FL, 335447351, US | 2553 WINDGUARD CIR, WESLEY CHAPEL, FL, 335447351, US | |||||||||||||||||||
|
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| Phone | +1 813-388-2948 |
| Fax | 8133886827 |
Authorized person
| Name | MAULIK BHALANI |
| Role | OWNER |
| Phone | 8133882948 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | ME102285 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Bhalani Seema | Agent | 1909 HAVEN BEND, TAMPA, FL, 33613 |
| Name | Role | Address |
|---|---|---|
| Bhalani Maulik MD | Manager | 1909 HAVEN BEND, TAMPA, FL, 33613 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-04-25 | Bhalani, Seema | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-04-25 | 1909 HAVEN BEND, TAMPA, FL 33613 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-01-26 |
| ANNUAL REPORT | 2016-04-25 |
| ANNUAL REPORT | 2015-03-20 |
| Florida Limited Liability | 2014-10-31 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
